Daniel Sullivan, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

087613 Issued in NY

Practice address

620 Route 303
Blauvelt, NY 10913-1170

Phone

(845) 353-2730

Fax

(845) 353-1513

NPI assigned

Dec 10, 2013

Sex

Male

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

• Daniel Sullivan Professional name

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.

• Coordinated Behavioral Care Ipa Inc

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1457881443
  NPD (past)
• Samaritan Daytop Village, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Blauvelt, NY
  • NPI 1134240344
  NPD (past)
• Samaritan Daytop Village, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • New York, NY
  • NPI 1326160904
  NPD (past)

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1396176772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 8TH AVE",
            "address_2": "SUITE300",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100186504",
            "telephone_number": "212-904-1500",
            "fax_number": "212-904-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 ROUTE 303",
            "city": "BLAUVELT",
            "state": "NY",
            "postal_code": "109131170",
            "telephone_number": "845-353-2730",
            "fax_number": "845-353-1513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "DANIEL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-10",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "087613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIEL",
            "last_name": "SULLIVAN",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• St.Dominic'S Home,Inc
• St.Dominic'S Home,Inc
• Samantha B Stark, LMSW
• Jamie Laurie Steiner, MHC-LP, CASAC-T
• Gregory Stemkowski, M.S. P.T.
• Niamh Theresa Taaffe
• TF Computation Inc.
• Vito Anthony Tomanelli, L.M.S.W.
• Tracey Polizzi, Psychology PH.D., P.C.
• Deborah J Traynor, COTA

• Social Worker in Blauvelt, NY
• Providers in Blauvelt, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.