Kathleen Frances Sullivan, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

006104 Issued in MI

Practice address

1945 Pauline Blvd
Suite 13B
Ann Arbor, MI 48103-5047

Phone

(734) 741-4940

Fax

(734) 741-8266

NPI assigned

Oct 23, 2005

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kathleen Diehl LMSW LLC

  • Social Worker
  • Ann Arbor, MI
  • NPI 1841049632
  NPD (past)
• Kristin Blackburn LMSW PLLC

  • Social Worker
  • Ann Arbor, MI
  • NPI 1386449031
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1932199874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 PAULINE BLVD",
            "address_2": "SUITE 13B",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481035047",
            "telephone_number": "734-741-4940",
            "fax_number": "734-741-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 PAULINE BLVD",
            "address_2": "SUITE 13B",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481035047",
            "telephone_number": "734-741-4940",
            "fax_number": "734-741-8266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KATHLEEN",
        "middle_name": "FRANCES",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "006104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Ann Sulfaro, LPC
• Mohamad Sulieman, DO
• Sarah Alyse Sulka, PHARMD
• Hillary Lynne Sullins Adland, LMSW
• Barbara-Jean B Sullivan, PH.D., NP
• Mark Scott Sullivan, PHD
• Michael Patrick Sullivan, MD
• Sullivan, Nolan & Associates, P.C.
• Omni Cherise Sullivan, NP
• Rachel Sullivan, MD

• Clinical Psychologist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.