Christianna Lynn Sullivan, LCSW LCPC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149020276 Issued in IL

Practice address

351 Williams LN
Chatham, IL 62629-1044

Phone

(217) 553-6678

NPI assigned

Nov 17, 2022

Last updated

Nov 17, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1668643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1366151367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 S GLENWOOD AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627043608",
            "telephone_number": "217-553-6678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 WILLIAMS LN",
            "city": "CHATHAM",
            "state": "IL",
            "postal_code": "626291044",
            "telephone_number": "217-553-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CHRISTIANNA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-17",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180011835",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149020276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Sloman, FNP
• Grant Stegman
• Gerald D Suchomski, M.D.
• Michelle Suess, SLP
• Sullivan Chiropractic Center P.C. (Sullivan Chiropractic Center)
• Kendra Lynn Sullivan, FNP-BC
• Maurice Eugene Sullivan III, D.C.
• Sunlight Counseling Services, PLLC
• John Bryan Taylor, D.C.
• Gina Thomas

• Clinical Social Worker in Chatham, IL
• Providers in Chatham, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.