Rebecha Kay Sullivan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

004850 Issued in CT

Practice address

35 Timberland Way
Southbury, CT 06488

Phone

(203) 915-7688

Fax

(203) 924-2334

NPI assigned

Oct 14, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Rebecha K Stockwell Former name

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 and National Provider Directory roles.

• Southbury Wellness Center, LLC

  • Community/Behavioral Health Agency
  • Southbury, CT
  • NPI 1508529173
  NPD Authorized official

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1255641072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 TIMBERLAND WAY",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "06488",
            "telephone_number": "203-915-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 TIMBERLAND WAY",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "06488",
            "telephone_number": "203-915-7688",
            "fax_number": "203-924-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "REBECHA",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-14",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECHA",
            "last_name": "STOCKWELL",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brittany Strebig, OD
• Rebecca Ann Strubbe, PA-C
• Stryjewski Chiropractic LLC
• Jason Thomas Stryjewski, D.C.
• Krista LD Stryjewski, RN, MSN, FNP-BC, DNP
• Prasad S Sureddi, MD
• Chin Cheng Tai
• Theresa Tartarone, MD
• Maryann Tavoletti, PT
• Kristian Laray Taylor

• Clinical Social Worker in Southbury, CT
• Providers in Southbury, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; 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.