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JENNIFER SULLIVAN
NPI 1568987378
Counselor - Mental Health in Bloomington, MN

Active since August 14, 2017PECOS EnrolledAccepts Medicare Assignment
1801 AMERICAN BLVD E STE 1, BLOOMINGTON, MN 55425(612) 331-9413 Get Directions Write a Review

NPPES record last updated: August 14, 2017. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Jennifer Sullivan NPPES

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

JENNIFER SULLIVAN (NPI 1568987378) is an individual mental health provider in Bloomington, Minnesota and active in the NPI registry since August 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2008).

NPPES Registry Identity

NPI1568987378
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJENNIFER SULLIVAN
Location Address1801 AMERICAN BLVD E STE 1Bloomington, MN 55425-1230
Mailing Address1801 American Blvd E Ste 1Bloomington, MN 55425-1230
Phone(612) 331-9413
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateAugust 14, 2017
✔ NPI 1568987378 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
1801 AMERICAN BLVD E STE 1, Bloomington, MN 55425
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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

Jennifer Sullivan 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 ID5597116780
PECOS Enrollment IDI20240112000152
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

2

Medicare enrollment records show Jennifer Sullivan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Eagan Counseling Clinic
5.3 mi
Clinical
3450 OLEARY LN
Eagan, MN 55123
  • Reassigned Medicare billing, Minnesota enrollment
  • 97 clinicians in this Medicare group
NPI 1144311184 (651) 454-0114
Fraser Child And Family Center
7.9 mi
Adolescent and Children Mental Health
3333 UNIVERSITY AVE SE
Minneapolis, MN 55414
  • Reassigned Medicare billing, Minnesota enrollment
  • 228 clinicians in this Medicare group
NPI 1609922194 (612) 331-9413

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 20

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

DR. DREW BENSON PH.D., L.P.
Psychologist
1801 AMERICAN BLVD E STE 1
BLOOMINGTON, MN 55425
Hennepin County (952) 767-2267
DR. KANGTING HEINS PH.D.
Psychologist
1801 AMERICAN BLVD E STE 1
BLOOMINGTON, MN 55425
Hennepin County (952) 737-6236
PAJAR MICHELLE LEE
Behavior Technician
1801 AMERICAN BLVD E STE 1
BLOOMINGTON, MN 55425
Hennepin County (952) 767-2267
JENNIFER RUTH STARKS MA, LMFT
Marriage & Family Therapist
1801 AMERICAN BLVD E STE 1
BLOOMINGTON, MN 55425
Hennepin County (952) 767-2267
MARIKO ORTNER LICSW
Social Worker (Clinical)
1801 AMERICAN BLVD E STE 1
BLOOMINGTON, MN 55425
Hennepin County (952) 767-7222
SARAH DAWN CROWLEY
Behavior Technician
1801 AMERICAN BLVD E STE 1
BLOOMINGTON, MN 55425
Hennepin County (612) 767-7222
KARMEN NYBERG OTR/L
Occupational Therapist
1801 AMERICAN BLVD E STE 1
BLOOMINGTON, MN 55425
Hennepin County (952) 767-2267
MRS. LEAH MARIE PALOMBO OTR/L
Occupational Therapist (Pediatrics)
1801 AMERICAN BLVD E STE 1
BLOOMINGTON, MN 55425
Hennepin County (612) 767-2267

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 Jennifer Sullivan's NPI number?

The NPI number for Jennifer Sullivan is 1568987378. It was assigned to this individual provider in the NPPES registry on August 14, 2017.

Where is Jennifer Sullivan located?

Jennifer Sullivan practices at 1801 American Blvd E Ste 1, Bloomington, MN 55425. The listed phone number is (612) 331-9413.

What is Jennifer Sullivan's specialty?

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

Is Jennifer Sullivan enrolled in Medicare?

Yes. Jennifer 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 Jennifer Sullivan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Sullivan reassigns Medicare benefits to 2 organizations: Eagan Counseling Clinic (Eagan, MN) and Fraser Child And Family Center (Minneapolis, MN). 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 Jennifer Sullivan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jennifer Sullivan was last updated on August 14, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.