KELLY SULLIVAN CAC III QMAP BA NPI 1093141178

NPI Information

  • NPI: 1093141178
  • Provider Name: KELLY SULLIVAN, CAC III, QMAP, BA
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 242 CONIFER ST
    FORT COLLINS, CO
    ZIP 80524
  • Phone: (970) 494-4200

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NPI Details

Kelly Sullivan, CAC III, QMAP, BA is an addiction (substance use disorder) counselor in Fort Collins, CO. Kelly Sullivan, CAC III, QMAP, BA NPI is 1093141178. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

242 CONIFER ST
FORT COLLINS, CO
ZIP 80524-043
Phone: (970) 494-4200

The enumeration date for this NPI number is 9/19/2013 and was last updated on 5/31/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)ACC.0006756COLORADOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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