Active NPI
Kathy Sullivan, MSW, PLCSW
- Clinical Social Worker
- Salisbury, NC
National Provider Identifier
1598096828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P005111
- Practice address
- 1601 Brenner Ave
Salisbury, NC 28144-2515 - Phone
- (704) 638-9000
- NPI assigned
- Jan 27, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P005111 | NC | Primary |
Addresses
Primary practice location
1601 Brenner Ave
Salisbury, NC 28144-2515
Mailing address
8702 Moody Rd
No. J
Liberty, NC 27298-9514
Phone (336) 622-1330
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P005111 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264550400000",
"number": "1598096828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8702 MOODY RD",
"address_2": "NO. J",
"city": "LIBERTY",
"state": "NC",
"postal_code": "272989514",
"telephone_number": "336-622-1330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 BRENNER AVE",
"city": "SALISBURY",
"state": "NC",
"postal_code": "281442515",
"telephone_number": "704-638-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "KATHY",
"credential": "MSW, PLCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-27",
"last_updated": "2010-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P005111",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salisbury, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.