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EDWARD BRADDOCK SULLIVAN
NPI 1063092633
Counselor in Olympia, WA

Active since April 08, 2021
3857 MARTIN WAY E, OLYMPIA, WA 98506(360) 704-7170 Get Directions Write a Review

NPPES record last updated: April 8, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Edward Braddock Sullivan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDWARD BRADDOCK SULLIVAN (NPI 1063092633) is an individual counselor in Olympia, Washington and active in the NPI registry since April 2021.

NPPES Registry Identity

NPI1063092633
Entity TypeIndividualMale
Primary Taxonomy101Y00000X
Provider Legal NameEDWARD BRADDOCK SULLIVAN
Location Address3857 MARTIN WAY EOlympia, WA 98506-5268
Mailing Address3857 Martin Way EOlympia, WA 98506-5268 · (253) 312-9057
Phone(360) 704-7170
Sole ProprietorYes
Enumeration DateApril 8, 2021
NPPES CertifiedApril 8, 2021
✔ NPI 1063092633 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
3857 MARTIN WAY E, Olympia, WA 98506
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PAMELA KAY BODINE
Counselor (Mental Health)
3857 MARTIN WAY E
OLYMPIA, WA 98506
Thurston County (360) 704-7170
ALYSSA COMPTON CLARK
Community Health Worker
3857 MARTIN WAY E
OLYMPIA, WA 98506
Thurston County (360) 704-7170
DANIELE BRITTNEY MAURER
Counselor (Mental Health)
3857 MARTIN WAY E
OLYMPIA, WA 98506
Thurston County (360) 704-7170
LEAH J VAN TIEM CLINICIAN
Counselor
3857 MARTIN WAY E
OLYMPIA, WA 98506
Thurston County (360) 704-7170
AMANDA VIOLET WELCH
Counselor
3857 MARTIN WAY E
OLYMPIA, WA 98506
Thurston County (360) 704-7170
ALYSSA LONG
Counselor
3857 MARTIN WAY E
OLYMPIA, WA 98506
Thurston County (360) 704-7170
GEORGE PETZINGER M.D.
Psychiatry & Neurology (Psychiatry)
3857 MARTIN WAY E
OLYMPIA, WA 98506
Thurston County (360) 704-7170
MS. FRANCES LYN HERTZ MA LMHC
Counselor (Mental Health)
3857 MARTIN WAY E
OLYMPIA, WA 98506
Thurston County (360) 704-7170

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edward Sullivan's NPI number?

The NPI number for Edward Sullivan is 1063092633. It was assigned to this individual provider in the NPPES registry on April 8, 2021.

Where is Edward Sullivan located?

Edward Sullivan practices at 3857 Martin Way E, Olympia, WA 98506. The listed phone number is (360) 704-7170.

What is Edward Sullivan's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Edward Sullivan was last updated on April 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.