Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Edison Sullivan, LPC

Individual provider Mental Health Counselor · NPI 1346056413

Edison Sullivan, LPC is a Mental Health Counselor in Van Buren, Arkansas. Qualified in 2021, 5 years ago. Practices with Restaura Arkansas LLC, a 5-clinician group and accepts Medicare assignment. Licensed in Arkansas.

Years since qualifying
5
Licensed in
AR
In the registry since
2024
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

3909 Highway 282
Van Buren, AR 72956-8718
Phone: (479) 242-1003
Fax: (501) 510-5917
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence P2411018 (AR)

Record details

NPI number1346056413
Entity typeIndividual (Type 1)
GenderMale
Credentials LPC
Sole proprietorYes
NPI enumeratedDecember 4, 2024
Last updated in NPPESDecember 4, 2024
Certification dateDecember 4, 2024
Mailing address3909 Highway 282, Van Buren, AR 72956-8718

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Restaura Arkansas Llc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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