Individual provider Active NPI

Thomas Patrick Sullivan, LMHC

  • Mental Health Counselor
  • Norwood, MA
National Provider Identifier
1992156426
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
9655 Issued in MA
Practice address
30 Walpole Street
Norwood, MA 02062-3356
Phone
(508) 667-8839
NPI assigned
Jun 27, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 9655 MA Primary

Addresses

Primary practice location

30 Walpole Street
Norwood, MA 02062-3356

Mailing address

30 Walpole St
Norwood, MA 02062-3356
Phone (508) 667-8839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20251122000116 MA Practitioner - Mental Health Counselor 6103318621 Practice locations: Norwood, MA

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

30 Walpole St
Norwood, MA 02062-3356
Phone (508) 667-8839

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9655MAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1992156426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WALPOLE ST",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020623356",
            "telephone_number": "508-667-8839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 WALPOLE STREET",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020623356",
            "telephone_number": "508-667-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "THOMAS",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-27",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "9655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

Verify at the official NPI Registry.