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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: October 18, 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
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

4

Medicare enrollment records show Edison Sullivan reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lumina Revenue Cycle Management LLC
Same address
Substance Abuse Rehabilitation Facility
3909 HIGHWAY 282
Van Buren, AR 72956
  • Reassigned Medicare billing, Arkansas enrollment
  • 8 clinicians in this Medicare group
NPI 1154894954 (479) 242-1003
Covenant Recovery Inc
97 mi
Substance Abuse Rehabilitation Facility
276 LINDEN ST
Hot Springs, AR 71901
  • Reassigned Medicare billing, Arkansas enrollment
  • 7 clinicians in this Medicare group
NPI 1467196386 (501) 226-6810
Recovery Resources LLC
124 mi
Rehabilitation, Substance Use Disorder
4621 ASHER AVE
Little Rock, AR 72204
  • Reassigned Medicare billing, Arkansas enrollment
  • 9 clinicians in this Medicare group
NPI 1659239564 (501) 454-6811
Restaura Arkansas LLC
159 mi
Substance Abuse Rehabilitation Facility
1301 RIDGWAY RD STE 1C
Pine Bluff, AR 71603
  • Reassigned Medicare billing, Arkansas enrollment
  • 7 clinicians in this Medicare group
NPI 1104663889 (870) 395-7341

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Which organizations bill Medicare for Edison Sullivan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Edison Sullivan reassigns Medicare benefits to 4 organizations: Lumina Revenue Cycle Management LLC (Van Buren, AR), Covenant Recovery Inc (Hot Springs, AR), Recovery Resources LLC (Little Rock, AR) and Restaura Arkansas LLC (Pine Bluff, AR). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Edison Sullivan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Edison Sullivan accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 4 other insurers 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 22 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.