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Miranda L Sullivan

Counselor β€’ Marion, IL

Active NPI 1235506981 Individual Practitioner Female Practitioner
Practice location in NPPES

1307 W Main St
Marion, IL 629591139

Call 8556083560 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1307 W Main St

Marion, IL 629591139

Telephone 8556083560
Fax 6189932969
Organization at the Same NPPES Address or Phone
Centerstone Of Illinois, Inc Facility NPI 1386969533

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2015

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Marion and Illinois

81 active clinicians are listed under Counselor with a practice address in Marion, IL (3,805 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Marion

1.2% of these 81 clinicians have the CMS telehealth indicator.

0% of these 81 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2021-01-29
Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

2 listed
Preston Simpson , MSW, LCSW

Social Worker - Clinical

NPI 1083249635

Master of Social Work, Licensed Clinical Social Worker

Brittany Vaughn , LCSW

Social Worker - Clinical

NPI 1033677687

Licensed Clinical Social Worker

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
πŸ“
Updated Practice Location January 29, 2021

Registered at 1307 W MAIN ST, MARION, IL 629591139 (Tel: 8556083560)

βœ…
NPI Profile Active August 28, 2015

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) August 28, 2015

Registered at 902 W MAIN ST, WEST FRANKFORT, IL 628962210 (Tel: 6189376483)

πŸ“
Business Mailing Address (Initial Record) August 28, 2015

Registered at 902 W MAIN ST, WEST FRANKFORT, IL 628962210 (Tel: 6189376483)

πŸ‘€
Provider Name / Credentials (Initial Record) August 28, 2015

Recorded as MIRANDA SULLIVAN

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 28, 2015

Counselor

🟒
Initial NPI Registration & Enumeration August 28, 2015

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1235506981
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 28, 2015
Last Update: January 29, 2021
Sole Proprietor: No

Mailing Address

902 W Main St

West Frankfort, IL 628962210

Phone: 6189376483

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.