Edward Mark Sullivan, MSW, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I0004577 Issued in OH

Practice address

570 N State St Ste 220C
Westerville, OH 43082-8086

Phone

(614) 696-8400

Fax

(614) 362-9909

NPI assigned

Feb 26, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH

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, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

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.

• Edward Mark Sullivan

  • Clinical Social Worker
  • Westerville, OH
  • NPI 1942063136
  NPD

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1659407674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 N STATE ST STE 220C",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430828086",
            "telephone_number": "614-696-8400",
            "fax_number": "614-362-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 N STATE ST STE 220C",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430828086",
            "telephone_number": "614-696-8400",
            "fax_number": "614-362-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "EDWARD",
        "middle_name": "MARK",
        "credential": "MSW, LISW-S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0004577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0243763",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "PO1698877",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0041581",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Subler-Smyke, MD
• Sheryl-Ann Suffren
• Andy Suh, DMD
• Steven Hwan Suh, M.D.
• Conor Sullivan
• Jenna Sullivan
• Melissa Sullivan, RD
• Iris Leyretana Sumatra, MA
• Nicole Elizabeth Summers, LISW
• Summerville at Outlook Manor, LLC

• Clinical Social Worker in Westerville, OH
• Providers in Westerville, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; 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.