Individual provider Active NPI

Rebecca Marie Sullivan, PLPC

  • Professional Counselor
  • Webster Groves, MO
National Provider Identifier
1962908830
Registry record updated Apr 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2017044761 Issued in MO
Practice address
330 N Gore Ave
Webster Groves, MO 63119-1600
Phone
(214) 919-4700
NPI assigned
Apr 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2017044761 MO Primary

Addresses

Primary practice location

330 N Gore Ave
Webster Groves, MO 63119-1600

Mailing address

330 N Gore Ave
Webster Groves, MO 63119-1600
Phone (314) 919-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2017044761MOMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1522540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522540800000",
    "number": "1962908830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N GORE AVE",
            "city": "WEBSTER GROVES",
            "state": "MO",
            "postal_code": "631191600",
            "telephone_number": "314-919-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N GORE AVE",
            "city": "WEBSTER GROVES",
            "state": "MO",
            "postal_code": "631191600",
            "telephone_number": "214-919-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "REBECCA",
        "middle_name": "MARIE",
        "credential": "PLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-01",
        "last_updated": "2018-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2017044761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster Groves, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.