Anthony Michael Sullivan, PSYD
NPI 1245362615ActiveIndividual· Psychologist, Clinical· Canon City, CO
Psychologist, Clinical (PSYD) with Sondermind Provider Network LLC, practicing in Canon City, Colorado. Medicare paid $23,956 for services to 25 patients in 2024.
Overview
| NPI | 1245362615 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PSYD |
| Sole proprietor | No |
| NPI issued | Mar 12, 2007 |
| Last updated in NPPES | Jul 29, 2020 |
| Certified by provider | Jul 29, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | 3490 | CO |
| Counselor, Professional | 101YP2500X | 2778 | CO |
| Psychologist | 103T00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (CO) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 25 |
|---|---|
| Services billed | 214 across 4 procedure codes |
| Paid by Medicare | $23,956 |
Education and affiliations
| Graduation year | 2004 |
|---|---|
| Medicare specialty | Clinical Psychologist |
| Telehealth | Offers telehealth |
Medical group
- Sondermind Provider Network LLCColumbus, OH · 1,339 clinicians
Other clinical psychologists in Canon City
- 1770275869