MALLORY SULLIVAN (NPI# 1174013841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174013841 |
| Entity Type | Individual |
| Full Name | MALLORY SULLIVAN |
| Credential | 222Q00000X |
| Practice Address |
1745 Hammonsville Jonesville Rd Magnolia KY 42757-7643 |
| Practice Telephone | 2707667598 |
| Mailing Telephone | 2707667598 |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2018-05-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | KY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124663331 | Mallory Breanna Sullivan | Registered Nurse | 80 Jesse Hill Jr Dr Se, Atlanta, GA 30303-3050 | 2019-11-12 |
| 1104219971 | Mallory Suzanne Sullivan | Counselor | 1101 Ball Ave Ne, Grand Rapids, MI 49505-5904 | 2015-03-18 |
| 1124311360 | Mallory Sullivan | Family Medicine | 117 W Main St, Suite 1, Waterville, NY 13480-1165 | 2011-05-20 |
| 1750689311 | Mallory Sullivan | Physician Assistant | 593 Eddy St, Providence, RI 02903-4923 | 2011-03-07 |
| Street Address |
1745 HAMMONSVILLE JONESVILLE RD |
| City | MAGNOLIA |
| State | KY |
| Zip Code | 42757-7643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467946624 | Playful Learning Interventions LLC | Early Intervention Provider Agency | 1745 Hammonsville Jonesville Rd, Magnolia, KY 42757-7643 | 2018-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750688552 | Kayla Renee Mcdowell | Developmental Therapist | 125 Mary Way Dr, Magnolia, KY 42757-7835 | 2011-02-15 |
| 1194775734 | Family Care Center Magnolia | Nurse Practitioner | 432 Mill Rd, Magnolia, KY 42757-7862 | 2006-05-12 |
| 1275803306 | Crystal Joseph | Pharmacist | 1045 Levi Beams Rd, Magnolia, KY 42757-7997 | 2012-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083215800 | Kellie Lynn Myers | Nurse Practitioner | 26015 Penguin St, Magnolia, TX 77355-6249 | 2020-11-06 |
| 1174122121 | John Mychal Thompson | Nurse Practitioner | 1411 Terrace, Magnolia, AR 71753-2040 | 2020-10-21 |
| 1902405905 | Cambron Counseling | Counselor | 33300 Egypt Ln Ste K900, Magnolia, TX 77354-3338 | 2020-10-21 |
| 1861091019 | Erin Quinn | Occupational Therapy Assistant | 7130 Durango Creek Dr, Magnolia, TX 77354-2781 | 2020-10-20 |
| 1497353411 | Evarose Terese Pepin | Behavior Technician | 31218 W Timberloch Trl, Magnolia, TX 77355-5871 | 2020-10-12 |
| 1063019784 | Charlene Phillips | Psychologist | 702 Woodlytown Rd, Magnolia, DE 19962-1622 | 2020-10-06 |
| 1841897048 | Farida Abdalla | Psychologist | 529 W Birdie Ln, Magnolia, DE 19962-3116 | 2020-10-01 |
| 1740897073 | Darlene Cunningham | Psychologist | 128 Glenn Forest Rd, Magnolia, DE 19962-1702 | 2020-09-30 |
| 1962019992 | Nina Galvan | Psychologist | 19 Edgewater Dr, Magnolia, DE 19962-9706 | 2020-09-24 |
| 1053926550 | Privia Medical Group Gulf Coast, Pllc | Internal Medicine | 10020 Research Forest Dr Ste D, Magnolia, TX 77354-6780 | 2020-09-11 |
| Find all providers in MAGNOLIA | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760830038 | Deborah Ellis | Developmental Therapist | 301 West Calhoun, Magnolia, ARKANSAS 71753 | 2016-05-27 |
| 1750688552 | Kayla Renee Mcdowell | Developmental Therapist | 125 Mary Way Dr, Magnolia, KY 42757-7835 | 2011-02-15 |
| 1366905002 | Allison Grace Saunders | Developmental Therapist | 301 W Calhoun, Magnolia, AR 71753-3508 | 2019-04-10 |
| 1326545708 | Kinder Saige Patton | Developmental Therapist | 301 W Calhoun, Magnolia, AR 71753-3508 | 2018-04-11 |
| 1801306857 | Chloe Arnold | Developmental Therapist | 301 W Calhoun, Magnolia, AR 71753-3508 | 2017-10-04 |
| 1972979318 | Rebecka Wendling | Developmental Therapist | 301 W Calhoun, Magnolia, AR 71753-3508 | 2015-08-20 |
| 1972945905 | Britnee S Weaver | Developmental Therapist | 301 W Calhoun, Magnolia, AR 71753-3508 | 2013-07-18 |
| 1417262171 | Sylvia Jean Crawford | Developmental Therapist | 301 W Calhoun, Magnolia, AR 71753-3508 | 2010-08-18 |
| 1790013480 | Wendi Michelle Pittman | Developmental Therapist | 301 W Calhoun, Magnolia, AR 71753-3508 | 2009-11-18 |
| 1164674396 | Angela G Gardner | Developmental Therapist | 301 W Calhoun, Magnolia, AR 71753-3508 | 2008-10-21 |
| Find all providers in MAGNOLIA | ||||
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| 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.