Active NPI
Sandra Marie Sullivan, LMSW
- Social Worker
- Binghamton, NY
National Provider Identifier
1013626324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 109248
- Practice address
- 275 Chenango St
Binghamton, NY 13901-2312 - Phone
- (607) 201-1204
- Fax
- (607) 201-1201
- NPI assigned
- Nov 16, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 109248 | NY | Primary |
Addresses
Primary practice location
275 Chenango St
Binghamton, NY 13901-2312
Mailing address
2570 Route 9W Ste 10
Cornwall, NY 12518-1370
Phone (845) 220-3100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109248 | NY | MD | Social Worker |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DGCECD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668643200000",
"number": "1013626324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2570 ROUTE 9W STE 10",
"city": "CORNWALL",
"state": "NY",
"postal_code": "125181370",
"telephone_number": "845-220-3100",
"fax_number": "845-534-2940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 CHENANGO ST",
"city": "BINGHAMTON",
"state": "NY",
"postal_code": "139012312",
"telephone_number": "607-201-1204",
"fax_number": "607-201-1201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "SANDRA",
"middle_name": "MARIE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-16",
"last_updated": "2022-11-17",
"certification_date": "2022-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "109248",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Binghamton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.