PHILIP SULLIVAN LLMSW NPI 1619769544

NPI Information

  • NPI: 1619769544
  • Provider Name: PHILIP SULLIVAN, LLMSW
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 1342 BALDWIN ST
    JENISON, MI
    ZIP 49428
  • Phone: (231) 535-2822

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NPI Details

Philip Sullivan, LLMSW is an addiction (substance use disorder) counselor in Jenison, MI. Philip Sullivan, LLMSW NPI is 1619769544. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1342 BALDWIN ST
JENISON, MI
ZIP 49428-937
Phone: (231) 535-2822

The enumeration date for this NPI number is 5/19/2025 and was last updated on 5/19/2025.

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)Yes

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: 11/21/2025

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