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1477710291 NPI number — ANDREA KAYE SULLIVAN MS, LPC

NPI Number: 1477710291
Health Care Provider/Practitioner: ANDREA KAYE SULLIVAN MS, LPC

Information about “1477710291” NPI (ANDREA KAYE SULLIVAN MS, LPC) exists in 1477710291 in HTML format HTML  |  1477710291 in plain Text format TXT  |  1477710291 in PDF (Portable Document Format) PDF  |  1477710291 in an XML format XML  formats.

NPI Number : 1477710291 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1477710291",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SULLIVAN",
    "FirstName": "ANDREA",
    "MiddleName": "KAYE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MS, LPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "GUFFEY",
    "OtherFirstName": "ANDREA",
    "OtherMiddleName": "KAYE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "251 JOHNSTON ST SE STE 100",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DECATUR",
    "MailingAddressStateName": "AL",
    "MailingAddressPostalCode": "35601-2515",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "256-822-2375",
    "MailingAddressFaxNumber": "256-584-2330",
    "FirstLinePracticeLocationAddress": "16 MOULTON ST E",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DECATUR",
    "PracticeLocationAddressStateName": "AL",
    "PracticeLocationAddressPostalCode": "35601-2310",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "256-822-2375",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/20/2008",
    "LastUpdateDate": "01/17/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "3066",
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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