SALLY SULLIVAN (NPI# 1174174940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174174940 |
| Entity Type | Individual |
| Full Name | SALLY SULLIVAN |
| Credential | LMHC |
| Practice Address |
4001 Office Court Dr Ste 102 Santa Fe NM 87507-4903 |
| Practice Telephone | 5059838225 |
| Practice Fax Number | 5059305427 |
| Mailing Telephone | 5059838225 |
| Mailing Fax Number | 5059305427 |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2020-08-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073907697 | Sally Sullivan | Counselor | 1202 Office Park Dr., Suite A, Oxford, MS 38655 | 2015-03-20 |
| 1609223205 | Sally Sullivan | Nurse Anesthetist, Certified Registered | 971 Lakeland Dr, Jackson, MS 39216-4643 | 2016-05-24 |
| Street Address |
4001 OFFICE COURT DR STE 102 |
| City | SANTA FE |
| State | NM |
| Zip Code | 87507-4903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093062945 | Sangeet Ram | Counselor | 4001 Office Court Dr Ste 102, Santa Fe, NM 87507-4903 | 2012-08-09 |
| 1275150997 | Emily Rothschild | Counselor | 4001 Office Court Dr Ste 102, Santa Fe, NM 87507-4903 | 2020-06-29 |
| 1558982025 | Lauren Michelle Roberts | Counselor | 4001 Office Court Dr Ste 102, Santa Fe, NM 87507-4903 | 2020-05-06 |
| 1679114227 | Allison Denise Hendricks | Counselor | 4001 Office Court Dr Ste 102, Santa Fe, NM 87507-4903 | 2019-10-04 |
| 1649827395 | Mary C Ray | Counselor | 4001 Office Court Dr Ste 102, Santa Fe, NM 87507-4903 | 2019-08-19 |
| 1477016590 | Sarah Barnard | Social Worker | 4001 Office Court Dr Ste 102, Santa Fe, NM 87507-4903 | 2019-04-08 |
| 1477029916 | Lisa Danner | Social Worker | 4001 Office Court Dr Ste 102, Santa Fe, NM 87507-4903 | 2018-10-23 |
| 1578045670 | Kris-ann Walters | Counselor | 4001 Office Court Dr Ste 102, Santa Fe, NM 87507-4903 | 2018-09-05 |
| 1851872139 | Kathleen S Knox | Counselor | 4001 Office Court Dr Ste 102, Santa Fe, NM 87507-4903 | 2018-08-24 |
| 1538640966 | Dana M Dean | Counselor | 4001 Office Court Dr Ste 102, Santa Fe, NM 87507-4903 | 2018-08-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093316390 | Cynthia Lois Meyers | Pharmacy | 2709 Cerrillos Road, Santa Fe, NM 87507 | 2020-11-03 |
| 1578160685 | Nancy Benigsohn | Counselor | 4001 Office Courte., Suite 603, Santa Fe, NM 87507 | 2020-10-02 |
| 1730684853 | Presbyterian Healthcare Services | General Acute Care Hospital | 4801 Beckner Road, Santa Fe, NM 87507 | 2018-03-29 |
| 1033623780 | Averie Montgomery-diener | Physical Therapy Assistant | 2538 Camino Entrad Suite 300, Santa Fe, NM 87507 | 2017-11-16 |
| 1013426790 | Deja Nicole Mendez | Behavior Technician | 2213 Paseo De Tercero, Santa Fe, NM 87507 | 2017-09-25 |
| 1548787633 | Lauren Sherwood | Behavior Technician | 4129 S Meadows Rd, Apt #1023, Santa Fe, NM 87507 | 2017-08-29 |
| 1972032563 | Alyssa Butler | Counselor | 1409 Zepol Rd Apt 110, Santa Fe, NM 87507 | 2017-06-07 |
| 1093253221 | Stateserv Medical | Durable Medical Equipment & Medical Supplies | 4326 Airport Road, Unit F, Santa Fe, NM 87507 | 2017-02-08 |
| 1891233128 | Daniel & Max, LLC | Optometrist | 4079 Cerillos Road, Santa Fe, NM 87507 | 2017-02-07 |
| 1508225749 | Youth Shelters and Family Services | Counselor | 5686 B Agua Fria Street, Santa Fe, NM 87507 | 2016-02-16 |
| Find all providers in zip 87507 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578160685 | Nancy Benigsohn | Counselor | 4001 Office Courte., Suite 603, Santa Fe, NM 87507 | 2020-10-02 |
| 1619584182 | Marybeth Hallman | Counselor | 1219 Luisa St Ste 10, Santa Fe, NM 87505-4176 | 2020-09-28 |
| 1619583366 | Kelsey Ullrich | Counselor | 409 Alejandro Street, Guest House, Santa Fe, NM 87501-8750 | 2020-09-18 |
| 1598370116 | Katie Monroe Therapy Services | Counselor | 5210 Via Del Valle, Santa Fe, NM 87507-3652 | 2020-09-10 |
| 1174131833 | James Ryan Dunn | Counselor | 15 Balsa Dr, Santa Fe, NM 87508-8317 | 2020-07-20 |
| 1104447093 | Dana Marie Tsyconyea Simmons | Counselor | 1640 Calle Medico, Suite E, Santa Fe, NM 87505 | 2020-05-01 |
| 1992345904 | Noranik Zadeyan | Counselor | 338 Rosario Hl, Santa Fe, NM 87501-1773 | 2020-01-08 |
| 1760024822 | Gary L Field | Counselor | 317 Staab St, Santa Fe, NM 87501-1844 | 2019-10-10 |
| 1962054833 | Julie Price | Counselor | 1435 S Saint Francis Dr Ste 101c, Santa Fe, NM 87505-4202 | 2019-07-11 |
| 1750940938 | Amanda Elizabeth Taylor | Counselor | 5686 Agua Fria St # B, Santa Fe, NM 87507-9001 | 2019-06-11 |
| Find all providers in SANTA FE | ||||
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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.