Nancy Anne Sullivan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

075477 Issued in NY

Practice address

9729 64TH Rd
Rego Park, NY 11374-2240

Phone

(718) 896-3400

Fax

(718) 459-5621

NPI assigned

Dec 3, 2008

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

Other identifiers 1

Other names 1

• Nancy Anne Watts Other name

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Clinical Social Worker

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/liccnewyorkcity/r4/

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.

• Nancy a Sullivan, LCSW PLLC

  • Clinical Social Worker
  • Fresh Meadows, NY
  • NPI 1144937160
  NPD Authorized official
• Nancy a. Sullivan, LCSW

  • Community/Behavioral Health Agency
  • Fresh Meadows, NY
  • NPI 1285076414
  NPD (past) Authorized official
• Long Island Consultation Center

  • Counselor
  • Elmhurst, NY
  • NPI 1356016703
  NPD (past)

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

{
    "created_epoch": "1228262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228262400000",
    "number": "1619112828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15913 HORACE HARDING EXPY",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113651424",
            "telephone_number": "917-575-2344",
            "fax_number": "718-262-1447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9729 64TH RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742240",
            "telephone_number": "718-896-3400",
            "fax_number": "718-459-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "NANCY",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-03",
        "last_updated": "2008-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "075477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244019",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "WATTS",
            "middle_name": "ANNE",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shradha Subba, R N
• Zina Sucharevski-Gotlieb, DDS
• Davia Elizabeth Sudlow
• Sharona Sufiyeva
• Erin Sullivan
• Norma Cecilia Sullivan
• Tarana Sultana
• Dan Summer, LCAT
• Summit Dental, P.C.
• Dongxing Sun, LAC

• Clinical Social Worker in Rego Park, NY
• Providers in Rego Park, 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 Dec 3, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.