Individual provider Active NPI

Ann Sullivan

  • Clinical Social Worker
  • Dunkirk, NY
National Provider Identifier
1649246646
Registry record updated Jul 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R014787 Issued in NY
Practice address
186 Lake Shore Dr W
Dunkirk, NY 14048-1437
Phone
(716) 366-6125
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2011

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 R014787 NY Primary

Addresses

Primary practice location

186 Lake Shore Dr W
Dunkirk, NY 14048-1437

Mailing address

186 Lake Shore Dr W
Dunkirk, NY 14048-1437
Phone (716) 366-6125

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
R014787NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service of the Chautauqua Region Inc Clinical PastSince Sep 19, 2005 Accepting new patients
Pine Valley Central School Past Accepting new patients
Chautauqua County Chapter of Nysarc Inc Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311552000000",
    "number": "1649246646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 LAKE SHORE DR W",
            "city": "DUNKIRK",
            "state": "NY",
            "postal_code": "140481437",
            "telephone_number": "716-366-6125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 LAKE SHORE DR W",
            "city": "DUNKIRK",
            "state": "NY",
            "postal_code": "140481437",
            "telephone_number": "716-366-6125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2011-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R014787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunkirk, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2011; 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.