Individual provider Active NPI

Erin Kelmartin Sullivan, LCSW-C

  • Clinical Social Worker
  • Rosedale, MD
National Provider Identifier
1073156345
Registry record updated Oct 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
25500 Issued in MD
Practice address
9627 Philadelphia Rd Ste 160
Rosedale, MD 21237-4157
Phone
(410) 780-5203
NPI assigned
Oct 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 25500 MD Primary

Addresses

Primary practice location

9627 Philadelphia Rd Ste 160
Rosedale, MD 21237-4157

Mailing address

9012 Tammy Rd
Nottingham, MD 21236-1834
Phone (410) 215-5414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20210111000189 MD Practitioner - Clinical Social Worker 4587077664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thrive Behavioral Health, LLCGroup PAC ID 3476777947, 62 clinicians

Practice addresses (Care Compare)

9627 Philadelphia Rd
Suite 160
Rosedale, MD 21237-4157
Phone (410) 780-5203

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Behavioral Health, LLC CurrentSince Dec 1, 2020 Accepting new patients
Thrive Behavioral Health, LLC CurrentSince Dec 1, 2020 Accepting new patients

Locations

1114 Benfield Blvd
Ste G
Millersville, MD 21108
Phone (410) 780-4320

9627 Philadelphia Rd
Ste 160
Rosedale, MD 21237
Phone (410) 780-5205

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1571443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571443200000",
    "number": "1073156345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9012 TAMMY RD",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212361834",
            "telephone_number": "410-215-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9627 PHILADELPHIA RD STE 160",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212374157",
            "telephone_number": "410-780-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ERIN",
        "middle_name": "KELMARTIN",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-19",
        "last_updated": "2019-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "25500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, MD

Sources for this page

Verify at the official NPI Registry.