Tiffany Noel Edmonds Sullivan, LCSW, JD

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904003782 Issued in VA

Practice address

205 Hampton Hwy
Yorktown, VA 23693

Phone

(757) 865-1843

NPI assigned

Aug 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Tiffany Noel Edmonds Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Juris Doctor

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.

• Chapman Senior Care, Inc.

  • Clinical Social Worker
  • Richmond, VA
  • NPI 1669439691
  NPD (past)
• Rock Landing Psychological Group PLC

  • Psychiatry Physician
  • Newport News, VA
  • NPI 1528159183

  Clinical

  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467568535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 HAMPTON HWY",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "23693",
            "telephone_number": "757-865-1843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 HAMPTON HWY",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "23693",
            "telephone_number": "757-865-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "TIFFANY",
        "middle_name": "NOEL EDMONDS",
        "name_prefix": "Ms.",
        "credential": "LCSW, JD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904003782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8924287",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "EDMONDS",
            "middle_name": "NOEL",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathy Coppa Stinson, OTD
• Jane Patricia Stockdale, OTR/L
• Lauri Roselle Stoltzfus, LPC
• Wayne A Stoutenger, MD
• Sara Stuffel
• Royce Sumayo
• Ann Marie Summerrise, IDMT
• Amani Machel Sutton Kicklighter, PHARMD, BCPS, BC-ADM
• Jamie Swale, DPT
• Sean Swaney, DO

• Clinical Social Worker in Yorktown, VA
• Providers in Yorktown, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.