Kevin P Sullivan, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2002032343 Issued in MO

Practice address

5000 Cedar Plaza Pkwy
Suite 350
Saint Louis, MO 63128-3854

Phone

(314) 843-4333

Fax

(314) 843-4856

NPI assigned

Nov 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1992879654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 CEDAR PLAZA PKWY",
            "address_2": "SUITE 350",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283854",
            "telephone_number": "314-843-4333",
            "fax_number": "314-843-4856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 CEDAR PLAZA PKWY",
            "address_2": "SUITE 350",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283854",
            "telephone_number": "314-843-4333",
            "fax_number": "314-843-4856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KEVIN",
        "middle_name": "P",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2002032343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO LICENSE",
            "identifier": "2002032343",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Cleary Sullivan, OD
• Gregory L Sullivan, D.C.
• Hannah Sullivan, MD
• Julie Ann Sullivan
• Karolyn Nicole Sullivan, MA, LPC
• Kimberly Denise Sullivan, R.N.
• Kimberly Evette Sullivan, RN, BSN
• Lauren K Sullivan, DPT
• Laurie Lucker Sullivan
• Mary E Sullivan, ACNP

• Professional Counselor in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.