Jeffrey Sullo, LPC is a medicare enrolled "Counselor - Professional" provider in Bethany, Connecticut. His current practice location is
27 Green Hill Rd, Bethany, Connecticut. You can reach out to his office (for appointments etc.) via phone at
(203) 931-5621.
Jeffrey Sullo is licensed to practice in Connecticut (license number 3074) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1508292475.
Healthcare Provider's Profile
Full Name | Jeffrey Sullo |
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Gender | Male |
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Speciality | Counselor - Professional |
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Location | 27 Green Hill Rd, Bethany, Connecticut |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1508292475
- Provider Enumeration Date: 09/23/2013
- Last Update Date: 11/13/2020
Medicare PECOS Information:
- PECOS PAC ID: 7012350341
- Enrollment ID: I20240202003872
Medical Identifiers
Medical identifiers for Jeffrey Sullo such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1508292475 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YP2500X | Counselor - Professional | 3074 (Connecticut) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jeffrey Sullo allows following entities to bill medicare on his behalf.
Entity Name | The Well Christian Counseling, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1578151221 PECOS PAC ID: 6204279532 Enrollment ID: O20240202003837 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jeffrey Sullo is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jeffrey Sullo, LPC 27 Green Hill Rd, Bethany, CT 06524-3324 Ph: (203) 931-5621 | Jeffrey Sullo, LPC 27 Green Hill Rd, Bethany, CT 06524-3324 Ph: (203) 931-5621 |
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