Provider Demographics
NPI:1881962702
Name:SULLIVAN, WHITNEY AUSTIN
Entity type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:AUSTIN
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7428 MANCHESTER CT
Mailing Address - Street 2:
Mailing Address - City:CASTLE PINES
Mailing Address - State:CO
Mailing Address - Zip Code:80108-8809
Mailing Address - Country:US
Mailing Address - Phone:863-206-7233
Mailing Address - Fax:888-510-5362
Practice Address - Street 1:7428 MANCHESTER CT
Practice Address - Street 2:
Practice Address - City:CASTLE PINES
Practice Address - State:CO
Practice Address - Zip Code:80108-8809
Practice Address - Country:US
Practice Address - Phone:863-206-7233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-06
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0006642235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP6269Medicaid
SCSA1359Medicaid