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Deactivated NPI 1295061364 Deactivated / Inactive NPI Male Practitioner

Dr. David S. Sullivan , PhD

Psychologist • Las Vegas, NV

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. David Sullivan has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 26, 2009
NPI Deactivation Date September 08, 2020
Total Practice Duration ~11 Years of Practice (2009 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. David Sullivan, PhD was a registered Psychologist practicing in Las Vegas, NV. Throughout an active medical career spanning 11 years, Dr. Sullivan provided care at the practice location at 2870 S MARYLAND PKWY until profile deactivation on 2020-09-08.

Practice Location & Contact Primary Location

Practice Address

2870 S Maryland Pkwy
210

Las Vegas, NV 891095031

Telephone 7025090056
Fax 7028971754
Associated Practice Facility / Clinic
🏢 Jacobs & Modaber Mds, Ltd. Facility NPI 1750454302

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Las Vegas, NV

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 18.6 Yrs
State Avg: 19.4 Yrs
Regional Practice Density
120 Specialists

Practicing in Las Vegas, NV (254 Statewide)

Telehealth Adoption Rate
5.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License NV PYT090928

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
NPI 1427140615

Doctor of Medicine (M.D.)

Robert Zieglmeier

Respiratory Therapist, Certified

NPI 1508287624
Dr. Parvin Jacobs , MD

Internal Medicine

NPI 1669545240

Doctor of Medicine (M.D.)

Cynthia Tiencharoen

Respiratory Therapist, Certified

NPI 1699191874
Mercy Quintanilla , PMHNP-BC

Nurse Practitioner - Psychiatric/Mental Health

NPI 1902598881

Psychiatric-Mental Health Nurse Practitioner (Board Certified)

Tara Clarkson

Respiratory Therapist, Certified

NPI 1932521515

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 08, 2020

Record deactivated on September 08, 2020

NPI Profile Active January 23, 2010

NPI status registered as active in NPPES database

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Updated Practice Location January 23, 2010

Registered at 2870 S MARYLAND PKWY, 210, LAS VEGAS, NV 891095031 (Tel: 7025090056)

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Updated Business Mailing Address January 23, 2010

Registered at 2870 S MARYLAND PKWY, 210, LAS VEGAS, NV 891095031 (Tel: 7025090056)

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Provider Name / Credentials Updated January 23, 2010

Recorded as DAVID SULLIVAN, PHD

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 23, 2010

Psychologist (License #PYT090928 in NV)

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Initial NPI Registration & Enumeration October 26, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1295061364
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 26, 2009
Last Update: January 23, 2010
Deactivation Date: September 08, 2020

Mailing Address

2870 S Maryland Pkwy, 210

Las Vegas, NV 891095031

Phone: 7025090056

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.