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MICHAEL GRUER SULLIVAN LMHC, MCAP
NPI 1063791747
Counselor - Mental Health in Lakeland, FL

Active since August 11, 2011
2024 N. CRYSTAL LAKE DR., SUITE 200 ROOM 205, LAKELAND, FL 33801(863) 410-2095 Get Directions Write a Review

NPPES record last updated: April 27, 2020. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Aug 17, 2017, Aug 11, 2017 (2 updates tracked since 2017).

About Michael Gruer Sullivan Lmhc, Mcap NPPES

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

MICHAEL GRUER SULLIVAN LMHC, MCAP (NPI 1063791747) is an individual mental health provider in Lakeland, Florida, licensed in Florida (MH15284) and active in the NPI registry since August 2011.

NPPES Registry Identity

NPI1063791747
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMICHAEL GRUER SULLIVANCredential: LMHC, MCAP
Location Address2024 N. CRYSTAL LAKE DR., SUITE 200 ROOM 205Lakeland, FL 33801-6015
Mailing Address503 Granby StLakeland, FL 33801-6015 · (863) 838-9437
Phone(863) 410-2095
Sole ProprietorNo
Enumeration DateAugust 11, 2011
Last NPPES UpdateApril 27, 20202 updates tracked since enumeration
NPPES CertifiedApril 27, 2020
✔ NPI 1063791747 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in FL · MH15284
Also ListedCounselorTaxonomy 101Y00000X · License MH15284 (FL)
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License MH15284 (FL)
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License MH15284 (FL)
2024 N. CRYSTAL LAKE DR., Lakeland, FL 33801
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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 Michael Sullivan's NPI number?

The NPI number for Michael Sullivan is 1063791747. It was assigned to this individual provider in the NPPES registry on August 11, 2011.

Where is Michael Sullivan located?

Michael Sullivan practices at 2024 N. Crystal Lake Dr. Suite 200 Room 205, Lakeland, FL 33801. The listed phone number is (863) 410-2095.

What is Michael 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 Michael Sullivan was last updated on April 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.