Kathleen M Sullivan, APRN
Nurse Practitioner, Psych/Mental Health in Lago Vista, Texas
1306095955- Practice location
- 20511 Sunset Ln, Lago Vista, TX 78645-6245
- Phone
- 860-460-1211
- Fax
- 860-760-6113
- Last updated
- May 19, 2026
Kathleen M. Sullivan is a Nurse Practitioner, Psych/Mental Health based in Lago Vista, TX. Kathleen M. Sullivan practices in Lago Vista, TX and has the professional credentials of APRN. The NPI Number for Kathleen M. Sullivan is 1306095955 and holds a License No. 3862 (CT). The current practice location address for Kathleen M. Sullivan is 20511 Sunset Ln, Lago Vista, TX 78645-6245 and can be reached out via phone at 860-460-1211 and via fax at 860-760-6113.
Provider Profile Details
- NPI Number
- 1306095955
- Provider Name
- Kathleen M. Sullivan
- Credential
- APRN
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 20511 Sunset Ln, Lago Vista, TX 78645-6245
- Phone Number
- 860-460-1211
- Fax Number
- 860-760-6113
- Primary Taxonomy
- Nurse Practitioner, Psych/Mental Health · 363LP0808X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- September 18, 2008
- Last Update Date
- May 19, 2026
- Certification Date
- May 19, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 20511 Sunset Ln
Lago Vista, TX 78645-6245 - City
- Lago Vista
- State
- Texas
- Zip
- 78645-6245
- Phone Number
- 860-460-1211
- Fax Number
- 860-760-6113
Provider Business Mailing Address Details
- Address
- 20511 Sunset Ln
Lago Vista, TX 78645-6245 - City
- Lago Vista
- State
- TX
- Zip
- 78645-6245
- Phone Number
- 860-460-1211
- Fax Number
- 860-460-1211
License Information
- License Number (1)
- 3862
- License State (1)
- CT
- Taxonomy (1)
- Nurse Practitioner, Psych/Mental Health · 363LP0808X
- License Number (2)
- NPP37789
- License State (2)
- RI
- Taxonomy (2)
- Nurse Practitioner, Psych/Mental Health · 363LP0808X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Nurse Practitioner, Psych/Mental Health providers near Lago Vista, TX
View all Nurse Practitioner, Psych/Mental Health providers in Lago Vista →Frequently Asked Questions
What is the NPI number of Kathleen M Sullivan, APRN?
The NPI number of Kathleen M Sullivan, APRN is 1306095955. It was assigned on September 18, 2008 and is currently active in the NPPES registry.
What is the specialty of Kathleen M Sullivan, APRN?
Kathleen M Sullivan, APRN is registered under the primary taxonomy Nurse Practitioner, Psych/Mental Health (code 363LP0808X), licensed in CT under license number 3862.
Where does Kathleen M Sullivan, APRN practice?
The practice location is 20511 Sunset Ln, Lago Vista, TX 78645-6245. The office can be reached at 860-460-1211 (phone) or 860-760-6113 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1306095955 directly on the NPPES registry website.