Suzette Marie Sullivan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

084985-1 Issued in NY

Practice address

10 N Main St
Cortland, NY 13045-2130

Phone

(607) 753-0234

NPI assigned

Sep 14, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Supportive Care Psychology of Ny PC

  • Clinical Psychologist
  • Howell, NJ
  • NPI 1104315068

  NY

  Medicare reassignment NPD
• Florida Therapy Services, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pensacola, FL
  • NPI 1407427800
  NPD (past)
• Northeast Health Services

  • Community/Behavioral Health Agency
  • Taunton, MA
  • NPI 1730525163
  NPD (past)
• Northeast Health Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Taunton, MA
  • NPI 1225067481
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637798400000",
    "number": "1003911025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 N MAIN ST",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130452130",
            "telephone_number": "607-753-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N MAIN ST",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130452130",
            "telephone_number": "607-753-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SUZETTE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2021-11-25",
        "certification_date": "2021-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084985-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336163963",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rose Keenan Streets, PA-C
• Kelly Strobeck, LMSW
• Stuart R Douglas DMD PLLC
• Stuart W. Gillim MDPC
• Valerie Meredith Potter Suk, LMT
• Rachelle L Sunderland, LMSW
• Diane R Sutton
• Charlotte Sweeney, LCSW
• Christine Marie Swenson, RN
• Biswarup Syam, MD

• Clinical Social Worker in Cortland, NY
• Providers in Cortland, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.