Individual provider Active NPI

Maeve Kathleen Sullivan

  • Social Worker
  • Danvers, MA
National Provider Identifier
1639716269
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
222604 Issued in MA
Practice address
199 Rosewood Dr
Danvers, MA 01923-1398
Phone
(978) 968-1700
NPI assigned
Dec 2, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 222604 MA Primary

Addresses

Primary practice location

199 Rosewood Dr
Danvers, MA 01923-1398

Mailing address

444 Washington St Ste 202
Woburn, MA 01801-1072
Phone (781) 929-5113

Other practice location 1

444 Washington St Ste 202
Woburn, MA 01801-1072
Phone (781) 929-5113

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

LicenseStateTypeSpecialty
222604MAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1639716269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 WASHINGTON ST STE 202",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011072",
            "telephone_number": "781-929-5113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 ROSEWOOD DR",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231398",
            "telephone_number": "978-968-1700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "444 Washington St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Woburn",
            "state": "MA",
            "postal_code": "018011072",
            "country_code": "US",
            "telephone_number": "781-929-5113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MAEVE",
        "middle_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "222604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; 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.