Elizabeth B. Sullivan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

088235 Issued in NY

Practice address

520 Franklin Ave
Garden City, NY 11530-5806

Phone

(516) 712-4919

NPI assigned

Mar 7, 2016

Sex

Female

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

Opted out of Medicare

Yes, effective Mar 18, 2022 through Mar 18, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1477913259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110500006",
            "telephone_number": "516-712-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 FRANKLIN AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305806",
            "telephone_number": "516-712-4919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Sunset Ave",
            "address_purpose": "LOCATION",
            "city": "Lynbrook",
            "state": "NY",
            "postal_code": "115634020",
            "country_code": "US",
            "telephone_number": "516-712-4919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ELIZABETH",
        "middle_name": "B.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-07",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irene Suba, PT
• Manoj K Subudhi, DO
• Mary Margaret Sugrue, MD
• Carol A Sullivan, M.S.
• Christine P Sullivan, LCSW
• Eugene Michael Sullivan, D.O.
• James M Sullivan Jr., MD
• Kaitlyn Lucille Sullivan, OTR/L
• Kelly Sullivan
• Roy F Sullivan, PH.D.

• Clinical Social Worker in Garden City, NY
• Providers in Garden City, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.