Nicole M Sullivan, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MF001484 Issued in PA

Practice address

510 Walnut St Ste 1425
Philadelphia, PA 19106-3622

Phone

(610) 892-3800

Fax

(484) 468-1412

NPI assigned

Feb 8, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole Mastracchio Former name

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

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.

• Delaware County Professional Services, Inc

  • Psychiatry Physician
  • Media, PA
  • NPI 1952485864
  Medicare reassignment

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

{
    "created_epoch": "1675814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1982301271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 WALNUT ST STE 1425",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063622",
            "telephone_number": "610-892-3800",
            "fax_number": "484-468-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 WALNUT ST STE 1425",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063622",
            "telephone_number": "610-892-3800",
            "fax_number": "484-468-1412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Market St Ste 720",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191062545",
            "country_code": "US",
            "telephone_number": "610-892-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-08",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "PA",
            "license": "MF001484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "MASTRACCHIO",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Sullivan, RN
• Matilda Daus Sullivan, DDS
• Megan Catherine Sullivan
• Meghan Sullivan, MSW, LCSW
• Narissa Sullivan
• Rachel Sullivan
• Ryan Sullivan
• Sally Sullivan, BSW
• Tiffany Diana Sullivan, MS, LPC
• Valerie Sullivan, RD, LDN

• Marriage & Family Therapist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Marriage & Family Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.