Nancy a Sullivan, LCSW PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

NANCY A SULLIVAN, LCSW PLLC

Practice address

159-13 Horace Harding Expwy
Fresh Meadows, NY 11365-1424

Phone

(917) 751-5952

Fax

(718) 460-5488

NPI assigned

Oct 31, 2022

Organization subpart

No

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

Authorized official

Name

Nancy A Sullivan, LCSWRNPI 1619112828

Title

Owner Sole Proprietor

Phone

(917) 751-5952

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nancy Anne Sullivan, LCSW

  • Clinical Social Worker
  • Rego Park, NY
  • NPI 1619112828
  NPD Authorized official

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677715200000",
    "number": "1144937160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159-13 HORACE HARDING EXPWY",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651424",
            "telephone_number": "917-751-5952",
            "fax_number": "718-460-5488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159-13 HORACE HARDING EXPWY",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651424",
            "telephone_number": "917-751-5952",
            "fax_number": "718-460-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANCY A SULLIVAN, LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-31",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER SOLE PROPRIETOR",
        "authorized_official_telephone_number": "917-751-5952",
        "authorized_official_credential": "LCSWR"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03887285",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• My RX Pharmacy Inc
• N & Z Health
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• Michelle Nadav
• Michal Namatiev, M.A.
• Nancy a. Sullivan, LCSW
• Barbara Nangle, MSED
• Irina Tabak Nattis
• Diana C Navia, MSED
• NCR Queens Urge Care International LLC

• Clinical Social Worker in Fresh Meadows, NY
• Providers in Fresh Meadows, 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 Mar 2, 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.

Verify at the official NPI Registry.