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MS. JESSIE ELAINE SULLIVAN LCPC,LMFT
NPI 1063674786
Counselor - Mental Health in Idaho Falls, ID

Active since June 25, 2008
660 S WOODRUFF AVE, IDAHO FALLS, ID 83401(208) 523-1558(208) 529-4788 Get Directions Write a Review

NPPES record last updated: June 16, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ms. Jessie Elaine Sullivan Lcpc,lmft NPPES

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

MS. JESSIE ELAINE SULLIVAN LCPC,LMFT (NPI 1063674786) is an individual mental health provider in Idaho Falls, Idaho, licensed in Idaho (LCPC-119) and active in the NPI registry since June 2008.

NPPES Registry Identity

NPI1063674786
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMS. JESSIE ELAINE SULLIVANCredential: LCPC,LMFT
Location Address660 S WOODRUFF AVEIdaho Falls, ID 83401-5299
Mailing Address3785 Colts Glen LnIdaho Falls, ID 83404-8353 · (208) 524-2411
Phone(208) 523-1558
Fax(208) 529-4788
Sole ProprietorYes
Enumeration DateJune 25, 2008
Last NPPES UpdateJune 16, 2011
✔ NPI 1063674786 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in ID · LCPC-119
Also ListedMarriage & Family TherapistTaxonomy 106H00000X · License LMFT-2963 (ID)
660 S WOODRUFF AVE, Idaho Falls, ID 83401
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Other Providers at the Same Location NPPES 2

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

SULLIVAN MENTAL HEALTH SERVICES LLC
Clinic/Center (Adult Mental Health)
660 S WOODRUFF AVE
IDAHO FALLS, ID 83401
Bonneville County (208) 523-1558
MRS. LISA LA'REE KISHIYAMA LMSW
Counselor (Professional)
660 S WOODRUFF AVE
IDAHO FALLS, ID 83401
Bonneville County (208) 523-1558

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 Jessie Sullivan's NPI number?

The NPI number for Jessie Sullivan is 1063674786. It was assigned to this individual provider in the NPPES registry on June 25, 2008.

Where is Jessie Sullivan located?

Jessie Sullivan practices at 660 S Woodruff Ave, Idaho Falls, ID 83401. The listed phone number is (208) 523-1558.

What is Jessie Sullivan's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Jessie Sullivan was last updated on June 16, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.