Active NPI
Evelyn Sullivan, LCSW
- Clinical Social Worker
- Lakewood, NJ
National Provider Identifier
1699862250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SC03531
- Practice address
- 700 Airport Rd
Lakewood, NJ 08701-5907 - Phone
- (732) 367-4700
- Fax
- (732) 364-2253
- NPI assigned
- Oct 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SC03531 | NJ | Primary |
Addresses
Primary practice location
700 Airport Rd
Lakewood, NJ 08701-5907
Mailing address
700 Airport Rd
P.O. Box 2036
Lakewood, NJ 08701-5907
Phone (732) 367-4700
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
| License | State | Type | Specialty |
|---|---|---|---|
| SC03531 | NJ | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699862250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 AIRPORT RD",
"address_2": "P.O. BOX 2036",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087015907",
"telephone_number": "732-367-4700",
"fax_number": "732-364-2253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 AIRPORT RD",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087015907",
"telephone_number": "732-367-4700",
"fax_number": "732-364-2253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "EVELYN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "SC03531",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.