VICTOR SULLIVAN JR. (NPI# 1558806505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558806505 |
| Entity Type | Individual |
| Full Name | VICTOR SULLIVAN JR. |
| Practice Address |
590 Ellis Rd S Jacksonville FL 32254-3555 |
| Practice Telephone | 9048002231 |
| Practice Fax Number | 9048002233 |
| Mailing Telephone | 9048002231 |
| Mailing Fax Number | 9048002233 |
| Enumeration Date | 2016-12-30 |
| Last Update Date | 2016-12-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
590 ELLIS RD S |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32254-3555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467838706 | Metro Treatment of Florida, Lp | Clinic/Center | 590 Ellis Rd S, Bldg. 4, Jacksonville, FL 32254-3555 | 2015-08-10 |
| 1295218311 | Erlinda Varone Lopez | Counselor | 590 Ellis Rd S, Jacksonville, FL 32254-3555 | 2018-09-14 |
| 1386122596 | Justin Burns | Counselor | 590 Ellis Rd S, Jacksonville, FL 32254-3555 | 2018-07-31 |
| 1053821264 | Sarah Elizabeth Patrick | Counselor | 590 Ellis Rd S, Jacksonville, FL 32254-3555 | 2017-10-03 |
| 1609312099 | Gregory Lee Cline | Counselor | 590 Ellis Rd S, Jacksonville, FL 32254 | 2017-01-10 |
| 1891230637 | Sabrina Noble | Counselor | 590 Ellis Rd S, Jacksonville, FL 32254-3555 | 2017-01-04 |
| 1063957801 | Shanga Wilson | Counselor | 590 Ellis Rd S, Jacksonville, FL 32254-3555 | 2017-01-04 |
| 1619412459 | David Cobb | Counselor | 590 Ellis Rd S, Jacksonville, FL 32254-3555 | 2017-01-04 |
| 1467997411 | Kolu Jennings | Counselor | 590 Ellis Rd S, Jacksonville, FL 32254-3555 | 2016-12-30 |
| 1366987372 | Kayla Adams | Counselor | 590 Ellis Rd S, Jacksonville, FL 32254-3555 | 2016-12-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730673385 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1301 W Palm Ave Ste 210, Jacksonville, FL 32254 | 2018-06-18 |
| 1578072112 | Jules M Jean-pierre | Counselor | 2392 North Edgewood Avenue, Jacksonville, FL 32254 | 2017-09-27 |
| 1356869051 | Volaura Shanae Anderson | Counselor | 590 Ellis Rd, Jacksonville, FL 32254 | 2017-09-01 |
| 1962928291 | Angel Spivie | Counselor | 590 Ellis Road South Building 4, Jacksonville, FL 32254 | 2017-08-18 |
| 1376072777 | Tarkeshia Shuman | Contractor | 3150 Broadway Ave, Jacksoville, FL 32254 | 2017-06-08 |
| 1770931636 | Mamie Faith Peterson-mclaurn | Home Health | 2747 Sophia St, Jax, FL 32254 | 2016-06-01 |
| 1760803373 | Marian Lavonne Jones | Custodial Care Facility | 3501 Centerhill Dr. North, Jacksonville, FL 32254 | 2013-12-27 |
| 1659543981 | Monique Bosque-perez | Family Medicine | 781 Edgewood Ave N, Ufjp Commonwealth Family Practice, Jacksonville, FL 32254 | 2008-03-26 |
| 1508906652 | James Keith Riesz | Physical Therapist | 800 Lomax Street, Suite 105, Jacksonville, FL 32254 | 2007-02-07 |
| 1003903865 | Sabrina F Sessions | Pharmacist | 5050 Edgewood Court, Jacksonville, FL 32254 | 2006-10-05 |
| Find all providers in zip 32254 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912514670 | William George Beasley Jr. | Counselor | 205 Sherwood Rd, Jacksonville, NC 28540-5534 | 2020-09-28 |
| 1881200053 | Sarah M Allen | Counselor | 307 Angelina St, Jacksonville, TX 75766-9212 | 2020-09-22 |
| 1265048797 | Victoria Payne | Counselor | 7848 Playpen Ct, Jacksonville, FL 32210-1420 | 2020-09-21 |
| 1982234100 | Sherree Smith | Counselor | 934 Lynchburg Dr, Jacksonville, NC 28546-4560 | 2020-01-16 |
| 1982266490 | Fernette R Hoag | Counselor | 3955 Riverside Ave Ste 211, Jacksonville, FL 32205-3312 | 2019-07-04 |
| 1942796347 | Gods House of Solomon | Counselor | 1709 Helena St, Jacksonville, FL 32208-3692 | 2018-07-09 |
| 1295223600 | Ronald North | Counselor | 4427 Emerson St, Jacksonville, FL 32207-4969 | 2018-05-01 |
| 1649768037 | Tiffany Angela Yarbough | Counselor | 4427 Emerson St # 4308, Jacksonville, FL 32207-4969 | 2018-05-01 |
| 1588160303 | Julie Margarita Smith | Counselor | 720 Seabrook Pkwy, Jacksonville, FL 32211-7153 | 2018-04-02 |
| 1689172587 | Rittie Ann Ragland | Counselor | 4720 S. Salisbury Rd Ste 103, Jacksonville, FL 32256-6101 | 2018-01-25 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32254 |
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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.