KEVIN A. SULLIVAN (NPI# 1457508996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457508996 |
| Entity Type | Individual |
| Full Name | KEVIN A. SULLIVAN |
| Credential | L.I.S.W. |
| Practice Address |
1500 W. Main St. Ste 300 Phoenix Counseling Sun Prairie WI 53590 |
| Mailing Address |
1532 W. Main St. Ste. 100 Sun Prairie WA 53590 |
| Practice Telephone | 6088256711 |
| Practice Fax Number | 6088346499 |
| Mailing Telephone | 6088257226 |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2008-08-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 328 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 39-728100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356886998 | Kevin Doerr Sullivan | Physician Assistant | 208 Cedar Creek Ter, Ione, WA 99139-5011 | 2017-01-05 |
| 1750734992 | Kevin Sullivan | Specialist/Technologist | 936 Wynn Rd, Mcdonough, GA 30252-5802 | 2016-07-22 |
| 1770638066 | Kevin Patrick Sullivan | Dentist | 305 E 2nd Ave, Ellensburg, WA 98926-3315 | 2007-01-24 |
| 1447276225 | Kevin L. Sullivan | Radiology | 250 Ponce De Leon Ave, Suite 100, Decatur, GA 30030-3406 | 2006-07-14 |
| 1750940615 | Kevin Thomas Sullivan | Dentist | 1475 Pine Grove Rd Ste 107, Steamboat Springs, CO 80487-8851 | 2019-06-13 |
| 1275196172 | Kevin Sullivan | Behavior Technician | 1301 E Orangewood Ave, Anaheim, CA 92805-6807 | 2019-04-16 |
| 1194245662 | Kevin Brian Sullivan | Military Health Care Provider | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2017-06-26 |
| 1467806125 | Kevin Sullivan | Hospitalist | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2016-04-19 |
| 1023479839 | Kevin Sullivan | Occupational Therapist | 5006 Copper Ave Ne, Albuquerque, NM 87108-1301 | 2016-03-08 |
| 1023478971 | Kevin Sullivan | Occupational Therapist | 7540 N 19th Ave Ste 200, Phoenix, AZ 85021-7967 | 2016-03-03 |
| Street Address |
1500 W. MAIN ST. STE 300 PHOENIX COUNSELING |
| City | SUN PRAIRIE |
| State | WI |
| Zip Code | 53590 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194280529 | Kasi Lucas Schroeder | Chiropractor | 110 N Grand Ave, Suite 4, Sun Prairie, WI 53590 | 2019-02-11 |
| 1770053712 | Jamie Engstrom | Psychologist | 3061 Pleasant St, 216, Sun Prairie, WI 53590 | 2018-12-03 |
| 1154837433 | Wisconsin Dental Health, LLC | Dentist | 390 S. Grand Ave, Suite#110, Sun Prairie, WI 53590 | 2017-12-21 |
| 1669981676 | Elizabeth M Gregg | Counselor | 1170 N Bird St, Sun Prairie, WI 53590 | 2017-09-21 |
| 1609298595 | Prairie Lakes Dental | Dentist | 2804 Prairie Lakes Drive, Sun Prairie, WI 53590 | 2014-01-10 |
| 1407297559 | Quality Medical Rides LLC | Non-emergency Medical Transport (VAN) | 2907 Vang Rd, Sun Prairie, WI 53590 | 2013-07-17 |
| 1376892851 | Costco Wholesale Corporation | Pharmacy | 2850 Hoepker Rd, Sun Prairie, WI 53590 | 2012-08-30 |
| 1043454234 | Dean Lewis Drake | Registered Nurse | 7281 County Rd V. V., Sun Prairie, WI 53590 | 2009-05-01 |
| 1679728992 | Dianne Mary Mayr | Registered Nurse | 3181 Nature Dr, Conservancy States Ln, Sun Prairie, WI 53590 | 2008-12-01 |
| 1043462021 | Crown Point Village, LLC | Assisted Living Facility | 881 Liberty Boulevard, Sun Prairie, WI 53590 | 2008-10-21 |
| Find all providers in zip 53590 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275962821 | Carrieann Zondag | Counselor | 883 St Albert Dr, Sun Prairie, WI 53590-4433 | 2013-11-04 |
| 1750719233 | Rochell D Floyd | Counselor | 778 Lois Dr., Sun Prairie, WI 53590-0002 | 2013-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528672326 | Myeshia Cunningham | Counselor | 3936 N 29th St, Milwaukee, WI 53216-2639 | 2020-08-31 |
| 1225646219 | Kaitlyn Schobert | Counselor | 6225 N Lake Dr, Whitefish Bay, WI 53217-4341 | 2020-07-16 |
| 1306464268 | Jennah E Benson | Counselor | 1 S Main Street, Janesville, WI 53545-3977 | 2020-07-08 |
| 1730704115 | Tanya Scheidegger | Counselor | 101 W Broadway # 2, Waukesha, WI 53186-4833 | 2020-06-11 |
| 1336762996 | Monica Lillian Cummings | Counselor | 7751 5th Ave, Kenosha, WI 53143-6006 | 2020-05-18 |
| 1235751447 | Luann Weik | Counselor | Childrens Hospital of Wi Genetics Center, 8915 W Connell Ct, Sta 716, Milwaukee, WI 53226-5322 | 2020-05-11 |
| 1053930867 | Jennifer Betters-bubon | Counselor | 127 E Prospect St, Stoughton, WI 53589-1650 | 2020-04-11 |
| 1700411048 | Kathleen M Allcox | Counselor | 4202 Monona Dr, Madison, WI 53716-1664 | 2020-03-06 |
| 1902437932 | Amanda Kay Harpt | Counselor | 516 Hilltop Dr, Green Bay, WI 54301-2718 | 2020-01-29 |
| 1912537333 | Jody Lee Erlicher | Counselor | 1114 S 11th St, Manitowoc, WI 54220-5217 | 2020-01-24 |
| Find all providers with the same taxonomy | ||||
| City | SUN PRAIRIE |
| Zip Code | 53590 |
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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.