C Stan Sullivan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

130803-3501 Issued in UT

Practice address

377 E Riverside Dr Ste B
St George, UT 84790

Phone

(435) 862-8273

Fax

(435) 275-4256

NPI assigned

Feb 20, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1329696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1407129588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 E RIVERSIDE DR STE B",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904749",
            "telephone_number": "435-862-8273",
            "fax_number": "435-275-4256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 E RIVERSIDE DR STE B",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "84790",
            "telephone_number": "435-862-8273",
            "fax_number": "435-275-4256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "377 E Riverside Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "St George",
            "state": "UT",
            "postal_code": "84790",
            "country_code": "US",
            "telephone_number": "435-862-8273",
            "fax_number": "435-275-4256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "C STAN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-20",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "130803-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Success Communications, LLC
• Herman Sufia
• Tiffanee Suhaka
• Ashlin Sullivan
• Aubree L Sullivan, LCSW
• Madison Sullivan
• Rachelle Sullivan, APRN- FNP-BC
• Rhett William Sullivan
• Taylor Sullivan, MSW
• Jenna T. Summerhays, FNP-C

• Clinical Social Worker in St George, UT
• Providers in St George, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.