Kerry Sullivan, LSW LCADC ICGC-1

Primary specialty

Social WorkerTaxonomy code 104100000X

License

44SL06785900 Issued in NJ

Practice address

536 Maple Ave
Linwood, NJ 08221-1213

Phone

(609) 517-0423

NPI assigned

May 3, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Above Water Recovery LLC

  • Adult Mental Health Clinic/Center
  • Linwood, NJ
  • NPI 1619701745
  NPD Authorized official

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

{
    "created_epoch": "1714694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1346097607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 E REVERE AVE",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082252436",
            "telephone_number": "609-513-2875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 MAPLE AVE",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082211213",
            "telephone_number": "609-517-0423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KERRY",
        "name_prefix": "Mrs.",
        "credential": "LSW LCADC ICGC-1",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-03",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06785900",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37L00351100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica M Steedle, M.A.
• Sara Steinbaum, DMD
• Raymond Albert Sterling, DDS
• Madison Lacey Stern, RD
• Nicole C Stroup, P.A
• Sunil K. Singh, MD, PA
• Surfside Psychiatry
• Surgery Center of Linwood LLC
• David O Sussman, D.O.
• David L Sykes, DMD

• Social Worker in Linwood, NJ
• Providers in Linwood, NJ by specialty
• Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; 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.