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EDISON SULLIVAN LPC
NPI 1346056413
Counselor - Mental Health in Van Buren, AR

Active since December 04, 2024PECOS EnrolledAccepts Medicare Assignment
3909 HIGHWAY 282, VAN BUREN, AR 72956(479) 242-1003(501) 510-5917 Get Directions Write a Review

NPPES record last updated: December 4, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Edison Sullivan Lpc NPPES

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

EDISON SULLIVAN LPC (NPI 1346056413) is an individual mental health provider in Van Buren, Arkansas, licensed in Arkansas (P2411018) and active in the NPI registry since December 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1346056413
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameEDISON SULLIVANCredential: LPC
Location Address3909 HIGHWAY 282Van Buren, AR 72956-8718
Mailing Address3909 Highway 282Van Buren, AR 72956-8718 · (479) 242-1003 · Fax (501) 510-5917
Phone(479) 242-1003
Fax(501) 510-5917
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateDecember 4, 2024
NPPES CertifiedDecember 4, 2024
✔ NPI 1346056413 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in AR · P2411018
3909 HIGHWAY 282, Van Buren, AR 72956
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Arkansas Blue Cross and Blue Shield, Health Advantage, Octave.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Edison Sullivan Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5496249872
PECOS Enrollment IDI20251212001267
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 7

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

LUMINA REVENUE CYCLE MANAGEMENT LLC
Substance Abuse Rehabilitation Facility
3909 HIGHWAY 282
VAN BUREN, AR 72956
Crawford County (479) 242-1003
JASON BYNUM CIT
Case Manager/Care Coordinator
3909 HIGHWAY 282
VAN BUREN, AR 72956
Crawford County (479) 242-1003
CANDICE HENDERSON LADAC
Counselor (Addiction (Substance Use Disorder))
3909 HIGHWAY 282
VAN BUREN, AR 72956
Crawford County (479) 242-1003
SARAH RACKLEY
Case Manager/Care Coordinator
3909 HIGHWAY 282
VAN BUREN, AR 72956
Crawford County (479) 242-1003
ALEXIS HOUSLEY
Case Manager/Care Coordinator
3909 HIGHWAY 282
VAN BUREN, AR 72956
Crawford County (479) 242-1003
JOSEPH BYNUM QBHP, ADC
Case Manager/Care Coordinator
3909 HIGHWAY 282
VAN BUREN, AR 72956
Crawford County (479) 242-1003
TRACY HENDERSON
Case Manager/Care Coordinator
3909 HIGHWAY 282
VAN BUREN, AR 72956
Crawford County (479) 242-1003

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 Edison Sullivan's NPI number?

The NPI number for Edison Sullivan is 1346056413. It was assigned to this individual provider in the NPPES registry on December 4, 2024.

Where is Edison Sullivan located?

Edison Sullivan practices at 3909 Highway 282, Van Buren, AR 72956. The listed phone number is (479) 242-1003.

What is Edison Sullivan's specialty?

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

Is Edison Sullivan enrolled in Medicare?

Yes. Edison Sullivan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Edison Sullivan accept?

Health plans from Arkansas Blue Cross and Blue Shield, Health Advantage and Octave list Edison Sullivan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Edison Sullivan was last updated on December 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.