Kimberly Paige Sullivan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW007302 Issued in GA

Practice address

PO Box 748465
Atlanta, GA 30374-8465

Phone

(229) 800-9695

Fax

(617) 807-0958

NPI assigned

May 3, 2018

Last updated

Apr 17, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1525305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1497244511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3673 MANHATTAN DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300346109",
            "telephone_number": "423-503-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 748465",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748465",
            "telephone_number": "229-800-9695",
            "fax_number": "617-807-0958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "445 Winn Way",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300301707",
            "country_code": "US",
            "telephone_number": "404-508-7700 x3533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KIMBERLY",
        "middle_name": "PAIGE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-03",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW008007",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francis J Sullivan, MD
• Harold Clifford Sullivan III
• Jermaine Nicholas Sullivan, NCC
• Karly Christine Sullivan
• Kenita A. Sullivan
• Mallory Breanna Sullivan
• Martin Anthony Sullivan, DC
• Mary Helen Sullivan, MSN, FNP-C
• Natalie Sullivan, MD
• Nechemyah Donte'-Devon Sullivan, LPC, NCC, ECMHC, CPS

• Clinical Social Worker in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.