Individual provider Active NPI

Mary E Sullivan, LCSW

  • Clinical Social Worker
  • Hightstown, NJ
National Provider Identifier
1609961630
Registry record updated May 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC04326100 Issued in NJ
Practice address
102 Main St
Suite 1
Hightstown, NJ 08520-4800
Phone
(609) 443-3970
Fax
(609) 443-8029
NPI assigned
Oct 4, 2006
Last updated
May 1, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC04326100 NJ Primary

Addresses

Primary practice location

102 Main St
Suite 1
Hightstown, NJ 08520-4800

Mailing address

102 Main St
Suite 1
Hightstown, NJ 08520-4800
Phone (609) 443-3970

Other identifiers 5

IdentifierTypeStateIssuer
167870OtherMHN
138555000OtherMAGELLAN
6276254OtherUNITED BEH HEALTH
11626OtherVALUE OPTIONS
P809023OtherOXFORD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20050419001190 NJ Practitioner - Clinical Social Worker 6800834052 Practice locations: Hightstown, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

102 Main St
Hightstown, NJ 08520-4800
Phone 60944339702

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC04326100NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Happens Counseling Service Clinical Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398902400000",
    "number": "1609961630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MAIN ST",
            "address_2": "SUITE 1",
            "city": "HIGHTSTOWN",
            "state": "NJ",
            "postal_code": "085204800",
            "telephone_number": "609-443-3970",
            "fax_number": "609-443-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MAIN ST",
            "address_2": "SUITE 1",
            "city": "HIGHTSTOWN",
            "state": "NJ",
            "postal_code": "085204800",
            "telephone_number": "609-443-3970",
            "fax_number": "609-443-8029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2014-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04326100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "167870",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "138555000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEH HEALTH",
            "identifier": "6276254",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "11626",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P809023",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hightstown, NJ

Sources for this page

Verify at the official NPI Registry.