Active NPI
Tiffani Sullivan, MS, LPC
- Professional Counselor
- Lakebay, WA
National Provider Identifier
1972144764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 75259
- Practice address
- 2908 205TH Ave SW
Lakebay, WA 98349-9469 - Phone
- (302) 359-2463
- NPI assigned
- Oct 2, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 75259 | TX | Primary |
| Mental Health Counselor | 101YM0800X | MHC.LH.61480747 | WA |
Addresses
Primary practice location
2908 205TH Ave SW
Lakebay, WA 98349-9469
Mailing address
2908 205TH Ave SW
Lakebay, WA 98349-9469
Phone (302) 359-2463
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)
- Enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788134400000",
"number": "1972144764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2908 205TH AVE SW",
"city": "LAKEBAY",
"state": "WA",
"postal_code": "983499469",
"telephone_number": "302-359-2463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2908 205TH AVE SW",
"city": "LAKEBAY",
"state": "WA",
"postal_code": "983499469",
"telephone_number": "302-359-2463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "TIFFANI",
"credential": "MS, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-02",
"last_updated": "2026-08-31",
"certification_date": "2026-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "75259",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MHC.LH.61480747",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakebay, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.