DEBORAH JEAN SULLIVAN (NPI# 1902065964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902065964 |
| Entity Type | Individual |
| Full Name | DEBORAH JEAN SULLIVAN |
| Credential | LADC |
| Practice Address |
1215 Se 7th Ave Grand Rapids MN 55744-4201 |
| Practice Telephone | 2183131338 |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2008-06-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
302323 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | IMCARE | 188856100 | 01 |
| MN | UBH/MEDICA | 84-10374 | 01 |
| MN | BCBS | 8199PNO | 01 |
| MN | PREFERRED ONE | 1021875 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568950152 | Deborah Hall Sullivan | Registered Nurse | 1000 Sanger Ave, Oceanport, NJ 07757-1241 | 2018-04-29 |
| 1275968927 | Deborah Mae Sullivan | Case Manager/Care Coordinator | 190 Mossy Oak Cir, North Augusta, SC 29841-3093 | 2013-09-12 |
| 1639419633 | Deborah Sullivan | Speech-Language Pathologist | 10140 Sw Paulina Dr, Tualatin, OR 97062-8549 | 2013-02-27 |
| 1972649143 | Deborah C. Sullivan | Dentist | 1200 U.S. Hwy 287 North, Suite 102, Mansfield, TX 76063 | 2007-01-29 |
| 1487643201 | Deborah Ann Sullivan | Genetic Counselor, MS | 182 Colon Ave, Staten Island, NY 10308-1405 | 2005-10-14 |
| 1023018900 | Deborah A Sullivan | Nurse Practitioner | 2139 N Academy Blvd, Colorado Springs, CO 80909-1507 | 2005-07-21 |
| 1730720327 | Deborah Sheryl Sullivan | Psychologist | 1384 Kempsville Rd, Norfolk, VA 23502-2299 | 2019-10-04 |
| 1699236224 | Deborah Katherine Sullivan | Counselor | 40700 California Oaks Rd Ste 202, Murrieta, CA 92562-5789 | 2019-03-27 |
| 1164816716 | Deborah Sullivan | Nurse Practitioner | 41 Mall Rd, Trauma Office 2t53, Burlington, MA 01805-0001 | 2015-03-22 |
| 1053740142 | Deborah Sullivan | Speech-Language Pathologist | 415 6th St, Lewiston, ID 83501-2431 | 2013-11-08 |
| Street Address |
1215 SE 7TH AVE |
| City | GRAND RAPIDS |
| State | MN |
| Zip Code | 55744-4201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619181492 | Jenny Wettersten | Psychologist | 1215 Se 7th Ave, Grand Rapids, MN 55744-4201 | 2007-05-10 |
| 1801428511 | Sara Sundquist Castle | Counselor | 1215 Se 7th Ave, Grand Rapids, MN 55744-4201 | 2020-02-11 |
| 1881040145 | Aricka Renee Meyer | Counselor | 1215 Se 7th Ave, Grand Rapids, MN 55744-4201 | 2016-05-05 |
| 1992185524 | Northland Recovery Center | Community/Behavioral Health | 1215 Se 7th Ave, Grand Rapids, MN 55744-4201 | 2015-06-09 |
| 1578962338 | Kelly Kerr | Counselor | 1215 Se 7th Ave, Grand Rapids, MN 55744-4201 | 2014-08-18 |
| 1558760322 | Kelly Owens | Counselor | 1215 Se 7th Ave, Grand Rapids, MN 55744-4201 | 2014-08-18 |
| 1326369869 | Laura Roy | Counselor | 1215 Se 7th Ave, Grand Rapids, MN 55744-4201 | 2010-06-18 |
| 1225215122 | Mark W. Anderson | Counselor | 1215 Se 7th Ave, Grand Rapids, MN 55744-4201 | 2008-01-23 |
| 1053500017 | Northland Counseling Center, Inc. | Substance Abuse Rehabilitation Facility | 1215 Se 7th Ave, Grand Rapids, MN 55744-4201 | 2007-10-16 |
| 1043428733 | Bruce Haag | Counselor | 1215 Se 7th Ave, Grand Rapids, MN 55744-4201 | 2007-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710587696 | Friesen & Friesen, Inc | Assisted Living Facility | 1971 Ne 1st Avenue, Grand Rapids, MN 55744 | 2020-10-29 |
| 1699392555 | Duane Stanley Helmer | Counselor | First Call for Help of Itasca County, 1707 Nw 4th Street Suite B, Grand Rapids, MN 55744 | 2020-06-26 |
| 1821631391 | Patrice Marie Curtiss | Technician | 23792 Winckler Road, Grand Rapids, MN 55744 | 2019-10-28 |
| 1578117438 | Christina Marie Hubred | Advanced Practice Dental Therapist | Miskovich Dental Clinic, 1121 Se 4th Avenue, Grand Rapids, MN 55744 | 2019-07-30 |
| 1780081877 | Fcsl Grand Rapids, LLC | Assisted Living Facility | 949 1/2 Sw 11th Street, Grand Rapids, MN 55744 | 2014-12-04 |
| 1912311333 | Doctor V LLC | Psychologist | 2002 Cromell Drive, Hope House of Itasca County, Laprairie, MN 55744 | 2014-06-13 |
| 1104244987 | Linda Reinen-thompson | Contractor | 34307 Hwy. 38, Grand Rapids, MN 55744 | 2014-03-31 |
| 1275883266 | Lana Rae Jacobson | Registered Nurse | 1401 Nw 9th Street, Grand Rapids, MN 55744 | 2012-09-17 |
| 1518252048 | David Allen Griggs | Pharmacist | 2140 S.pokegama Ave., T-0904, Target, Grand Rapids, MN 55744 | 2011-06-13 |
| 1447575063 | Kelly Ann Shermoen | Pharmacist | 18 Se 10th Street, Grand Rapids, MN 55744 | 2010-04-07 |
| Find all providers in zip 55744 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891302717 | Paige J Welch | Counselor | 1509 Diamond Ave Ne, Grand Rapids, MI 49505-5217 | 2020-09-24 |
| 1588277040 | Gregory Dean Retzlaff | Counselor | 2043 Rowe Ave Ne, Grand Rapids, MI 49505-4238 | 2020-08-25 |
| 1699392555 | Duane Stanley Helmer | Counselor | First Call for Help of Itasca County, 1707 Nw 4th Street Suite B, Grand Rapids, MN 55744 | 2020-06-26 |
| 1649779927 | Larry Mitchell | Counselor | 1960 Millbrook St Se, Grand Rapids, MI 49508-2636 | 2018-02-01 |
| 1235657388 | Courtney Albin | Counselor | 2504 Ardmore St Se Ste 202b, Grand Rapids, MI 49506-4901 | 2017-09-08 |
| 1649712001 | Alexander C Meyer | Counselor | 1200 S Pokegama Ave Ste 160, Grand Rapids, MN 55744-4296 | 2016-11-15 |
| 1871048934 | Nicole Nutt | Counselor | 32 Winter Ave Sw Apt 228, Grand Rapids, MI 49504-6488 | 2016-08-18 |
| 1306247564 | Krystal Strotbaum | Counselor | 5242 Plainfield Ave Ne Ste E, Grand Rapids, MI 49525-1084 | 2014-09-08 |
| 1710390372 | Laura Meeker Wicksall | Counselor | 1430 Robinson Rd Se Ste 206, Grand Rapids, MI 49506-1723 | 2014-06-11 |
| 1023358314 | Carole Lynn Walters | Counselor | 959 Wealthy St Se, Grand Rapids, MI 49506-2519 | 2013-02-22 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 55744 |
Please comment or provide details below to improve the information on DEBORAH JEAN 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.