Active NPI
Holly Ann Sullivan, MSW, LCSW
- Clinical Social Worker
- Phoenix, AZ
National Provider Identifier
1346422011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 34406 N 27TH Dr
Phoenix, AZ 85085-6082 - Phone
- (602) 492-1886
- NPI assigned
- Dec 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
34406 N 27TH Dr
Phoenix, AZ 85085-6082
Mailing address
34406 N. 27TH Drive
Phoenix, AZ 85085
Phone (602) 492-1886
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2021 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1346422011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34406 N. 27TH DRIVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85085",
"telephone_number": "602-492-1886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34406 N 27TH DR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850856082",
"telephone_number": "602-492-1886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "HOLLY",
"middle_name": "ANN",
"credential": "MSW, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-04",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.