TRACY LYNN SULLIVAN (NPI# 1114531738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114531738 |
| Entity Type | Individual |
| Full Name | TRACY LYNN SULLIVAN |
| Credential | LCPC |
| Practice Address |
40 2nd St E Ste 230 Kalispell MT 59901-6114 |
| Practice Telephone | 4063516636 |
| Mailing Telephone | 4063516636 |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2020-10-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
BBH-LCPC-LIC-189 | MT | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821198326 | Tracy L Sullivan | Audiologist | 13 2nd St Sw, Le Mars, IA 51031-2007 | 2006-09-24 |
| 1558962548 | Tracy Michelle Sullivan | Pharmacist | 5433 Reidland Rd, Paducah, KY 42003-0954 | 2020-11-05 |
| 1689829368 | Tracy Sullivan | Psychologist | 1270 Kings Hwy, Lewes, DE 19958-1735 | 2008-11-24 |
| 1902989957 | Tracy Sullivan | Nurse Practitioner | 3001 Expressway Drive North, Suite #116, Islandia, NY 11749 | 2006-10-23 |
| 1275547101 | Tracy C Sullivan | Dentist | 1880 Pottery Ave, Suite 200, Port Orchard, WA 98366-2518 | 2006-07-28 |
| Street Address |
40 2ND ST E STE 230 |
| City | KALISPELL |
| State | MT |
| Zip Code | 59901-6114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164770301 | Sean Patrick | Counselor | 40 2nd St E Ste 230, Kalispell, MT 59901-6114 | 2012-08-20 |
| 1578006383 | Meghan Gill | Psychologist | 40 2nd St E Ste 230, Kalispell, MT 59901-6114 | 2016-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982226650 | Mountain Physical Therapy and Fitness Center LLC | Physical Medicine & Rehabilitation | 2593 Highway 2 East, Suite 6, Kalispell, MT 59901 | 2020-05-15 |
| 1164058350 | Jessica Leeann Abell | Physical Therapist | 1825 Highway 93 S. Suite C, Kalispell, MT 59901 | 2020-03-19 |
| 1588216535 | Diversified Therapeutic Services, Pllc | Clinic/Center | 30 E Washinton St, Suite A, Kalispell, MT 59901 | 2019-07-10 |
| 1467986216 | Jill Shaver | Counselor | 285 2nd Avenue Wn, Suite #100, Kalispell, MT 59901 | 2017-04-19 |
| 1003270810 | Angela Otto | Counselor | 17 2nd St E Ste 204, Kalispell, MT 59901 | 2016-04-07 |
| 1548626989 | Pamela Greskowiak | Counselor | 2282 Hwy 93 South, Suite #1, Kalispell, MT 59901 | 2016-01-14 |
| 1063894921 | Joel Booth | Dentist | 690 N Meridian Rd Ste 106, Kalispell, MT 59901 | 2015-06-26 |
| 1982085841 | Heather Reddig | Specialist | 751 Snowberry Trail, Kalispell, MT 59901 | 2015-06-16 |
| 1497147193 | Patricia Greene Hall | Psychologist | 1035 1st Ave W Fl 3, Kalispell, MT 59901 | 2015-03-04 |
| 1720478886 | Lori Mariani | Social Worker | 1605 Danielson Road, Kalispell, MT 59901 | 2015-01-28 |
| Find all providers in zip 59901 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154964302 | Camille Deitz | Counselor | 17 2nd St E Ste 210, Kalispell, MT 59901-4500 | 2019-10-21 |
| 1033778105 | Stephen Marten | Counselor | 151 Business Center Loop, Kalispell, MT 59901-8559 | 2019-06-11 |
| 1407347164 | Diane Vonderheide | Counselor | 100 Financial Dr Ste 150, Kalispell, MT 59901-6002 | 2018-05-29 |
| 1346791241 | Julie Frederick | Counselor | 1354 Airport Rd, Kalispell, MT 59901-5701 | 2016-10-17 |
| 1467800235 | Greg Windham | Counselor | 1416 Woodland Ave, Kalispell, MT 59901-5147 | 2016-06-02 |
| 1275900078 | Kathryn Ryen | Counselor | 18 W Evergreen Dr, Kalispell, MT 59901-2810 | 2015-08-27 |
| 1164770301 | Sean Patrick | Counselor | 40 2nd St E Ste 230, Kalispell, MT 59901-6114 | 2012-08-20 |
| 1477835478 | Robin H Celkupa | Counselor | 690 N Meridian Rd Ste 205, Kalispell, MT 59901-3508 | 2011-09-15 |
| 1396042842 | Jennifer Kay Prendergast | Counselor | 322 2nd Ave W, Kalispell, MT 59901-4894 | 2011-02-18 |
| 1861714537 | Allyson Norwood Bush | Counselor | 723 5th Ave E # 10c, Kalispell, MT 59901-5321 | 2010-02-23 |
| Find all providers in KALISPELL | ||||
Please comment or provide details below to improve the information on TRACY LYNN SULLIVAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.