Janice Lynn Sudulich, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

077629-1 Issued in NY

Practice address

725 Veterans Memorial Highway
Hauppauge, NY 11788

Phone

(631) 853-6410

Fax

(631) 853-6413

NPI assigned

Jul 18, 2011

Last updated

Jul 18, 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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

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.

• County of Suffolk

  dba Suffolk County Department of Health Services

  • Public Health or Welfare Agency
  • Great River, NY
  • NPI 1285750737
  NPD
• County of Suffolk

  • Methadone Clinic
  • Smithtown, NY
  • NPI 1649374851
  NPD
• Suffolk County Department of Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Farmingville, NY
  • NPI 1700989050
  NPD

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310947200000",
    "number": "1285922799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 STORM DR",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117421915",
            "telephone_number": "631-853-6410",
            "fax_number": "631-853-6413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 VETERANS MEMORIAL HIGHWAY",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "11788",
            "telephone_number": "631-853-6410",
            "fax_number": "631-853-6413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDULICH",
        "first_name": "JANICE",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-18",
        "last_updated": "2011-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077629-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Louis Stone II, LMHC, LCAT
• Joseph Anthony Stopanio, PSY.D.
• Laura Strange
• Michelle Katherine Straub
• Joseph P Stubel, MD
• Suffolk Acupuncture Wellness P.C
• Suffolk Ambulatory Surgery Facility
• Suffolk Cty Dept of Health Services
• Suffolk Oral and Maxillofacial Ambulatory Surgery Facility, P.C.
• Kaitlyn Sullivan

• Clinical Social Worker in Hauppauge, NY
• Providers in Hauppauge, 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 Jul 18, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.