Maren Sullivan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

25277 Issued in CA

Practice address

11080 W Olympic Blvd
Los Angeles, CA 90064-1937

Phone

(310) 966-6500

NPI assigned

Dec 11, 2007

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 CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wellmind Online Ca Licensed Clinical Social Worker Prof Corp

  • Psychiatry Physician
  • Palo Alto, CA
  • NPI 1447871272

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302739200000",
    "number": "1598948739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11080 W OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641937",
            "telephone_number": "310-966-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11080 W OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641937",
            "telephone_number": "310-966-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MAREN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-11",
        "last_updated": "2011-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "25277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asia Jasmine Sullivan, PA-C
• Corissa Dante' Sullivan
• Hannah Leigh Sullivan
• Kathryn Ann Sullivan, AU.D.
• Lindsay Claire Sullivan, MA
• Melissa Nicole Sullivan, MD
• Peggy S Sullivan, MD
• Rachael Christine Sullivan
• Seamus Sullivan
• Sean Sullivan

• Clinical Social Worker in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.