Ann Marie Sumpter, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

Myers Counseling Group
300 Memorial Suite 200
Crystal Lake, IL 60014

Phone

(847) 263-1269

Fax

(847) 263-1310

NPI assigned

Dec 29, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Myers Counseling Group

  • Professional Counselor
  • Crystal Lake, IL
  • NPI 1215176698
  NPD (past)

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063578557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10N051 KENDALL RD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601238267",
            "telephone_number": "847-464-5617",
            "fax_number": "847-464-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MYERS COUNSELING GROUP",
            "address_2": "300 MEMORIAL SUITE 200",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014",
            "telephone_number": "847-263-1269",
            "fax_number": "847-263-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMPTER",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "6972-123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16587",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Longcheng Su, MD
• Ann C Sullivan
• Karen Sullivan
• Rebecca Sullivan, NP
• Timothy P Sullivan, D.D.S.
• Xuefan Sun, PHARMD
• Superior Health and Wellness of Crystal Lake, LTD.
• Sean Mark Labastida Superticioso, PT
• Nicolette Surico, LCPC
• Richard Joseph Surowiak, O.D.

• Clinical Social Worker in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.