MRS. TYESHA T SULLIVAN LMFT
NPI 1871246462
Marriage & Family Therapist in Stockton, CA

Q: What is Tyesha Sullivan's NPI number?

The NPI number for Tyesha Sullivan is 1871246462. It was assigned to this individual provider in the NPPES registry on February 2, 2022.

Q: What is Tyesha Sullivan's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: When was this NPI record last updated?

The NPPES record for Tyesha Sullivan was last updated on August 8, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since February 02, 2022PECOS Enrolled

540 N CALIFORNIA ST, STOCKTON, CA 95202(209) 464-4524 Get Directions Write a Review

NPPES record last updated: August 8, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 8, 2023, Feb 2, 2022 (2 updates tracked since 2022).

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About Mrs. Tyesha T Sullivan Lmft NPPES

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

MRS. TYESHA T SULLIVAN LMFT (NPI 1871246462) is an individual marriage & family therapist in Stockton, California, licensed in California (123866) and active in the NPI registry since February 2022. She is enrolled in Medicare PECOS and maintains a secondary practice location in Stockton.

NPPES Registry Identity

NPI1871246462

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameMRS. TYESHA T SULLIVANCredential: LMFT

Location Address540 N CALIFORNIA STStockton, CA 95202-2117

Mailing Address4447 Abruzzi CirStockton, CA 95206-6097 · (209) 818-4711

Phone(209) 464-4524

Sole ProprietorNo

Enumeration DateFebruary 2, 2022

Last NPPES UpdateAugust 8, 20232 updates tracked since enumeration

NPPES CertifiedAugust 8, 2023

✔ NPI 1871246462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · 123866

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

540 N CALIFORNIA ST, Stockton, CA 95202

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Secondary Practice Location 1

Location 14447 Abruzzi CirStockton, CA 95206-6097 · Phone (209) 818-4711

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Tyesha T Sullivan Lmft is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.