Beth Sullivan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

216769 Issued in MA

Practice address

5 Hall Ave
Somerville, MA 02144-2003

Phone

(617) 623-3278

NPI assigned

May 23, 2011

Last updated

May 23, 2011By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Riverside Community Care IncGroup PAC ID 6709799885, 117 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Riverside Community Care, Inc.

  • Community/Behavioral Health Agency
  • Norwood, MA
  • NPI 1780791467
  Medicare reassignment Care Compare group NPD
• Riverside Community Care

  • Community/Behavioral Health Agency
  • Dedham, MA
  • NPI 1386195030
  NPD (past)

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

{
    "created_epoch": "1306108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306108800000",
    "number": "1255624391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HALL AVE",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442003",
            "telephone_number": "617-623-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 HALL AVE",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442003",
            "telephone_number": "617-623-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-23",
        "last_updated": "2011-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "216769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Duncan Stuard
• Ingo H Stubbe, MD
• Lilly Su
• Lucy Subler, RN
• Successful Expression, LLC
• Trisha Sullivan, CLMT
• Anthony Sullo
• Penelope Summerall
• John Summersby
• Meera Sunder, MD

• Clinical Social Worker in Somerville, MA
• Providers in Somerville, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.