Active NPI
Patricia Lind Sullivan, LCSW-C, J.D.
- Social Worker
- Fort Cavazos, TX
National Provider Identifier
1043458193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 13733
- Practice address
- 36065 Santa Fe Ave
Fort Cavazos, TX 76544-5060 - Phone
- (254) 288-8000
- NPI assigned
- Jan 28, 2009
- 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 | 13733 | MD | Primary |
Addresses
Primary practice location
36065 Santa Fe Ave
Fort Cavazos, TX 76544-5060
Mailing address
PO Box 31001-0698
Pasadena, CA 91110-0698
Phone (602) 263-1200
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)
- Enrolled
- Credentials
- Juris Doctor
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13733 | MD | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687305600000",
"number": "1043458193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31001-0698",
"city": "PASADENA",
"state": "CA",
"postal_code": "911100698",
"telephone_number": "602-263-1200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36065 SANTA FE AVE",
"city": "FORT CAVAZOS",
"state": "TX",
"postal_code": "765445060",
"telephone_number": "254-288-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "PATRICIA",
"middle_name": "LIND",
"name_prefix": "Mrs.",
"credential": "LCSW-C, J.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-28",
"last_updated": "2023-06-21",
"certification_date": "2023-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "13733",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Cavazos, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.