Dolly L Sullivan, LICSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

BP00943037 Issued in WV

Practice address

937 Cheat Rd
Morgantown, WV 26508-5631

Phone

(304) 288-3504

Fax

(304) 777-4487

NPI assigned

Jan 16, 2008

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

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Intentional Wellness and Consulting

  • Clinical Social Worker
  • Morgantown, WV
  • NPI 1568817674
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1467638882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 CHEAT RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265085631",
            "telephone_number": "304-288-3504",
            "fax_number": "304-777-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 CHEAT RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265085631",
            "telephone_number": "304-288-3504",
            "fax_number": "304-777-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "DOLLY",
        "middle_name": "L",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-16",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "BP00943037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Anne Suelter
• Alexandra E Suen, LPC
• Kyle Daniel Suiter
• Abdullahi Adedotun Sulaiman, M.D
• Carl Rollynn Sullivan III, M.D.
• Joshua Sullivan
• Julia W Sullivan, CRNA
• Shumaila Sultan, MD
• Haley Summerfield, PA-C
• Tiffany Dawn Summerlin, RDH

• Social Worker in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.