Rebecca Sullivan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34003487 Issued in IN

Practice address

615 N 18TH St
Suite 101
Lafayette, IN 47904-3410

Phone

(765) 423-5361

Fax

(765) 742-8272

NPI assigned

Nov 1, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1740367291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 N 18TH ST",
            "address_2": "SUITE 101",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479043410",
            "telephone_number": "765-423-5361",
            "fax_number": "765-742-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N 18TH ST",
            "address_2": "SUITE 101",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479043410",
            "telephone_number": "765-423-5361",
            "fax_number": "765-742-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "REBECCA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "251500A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ariel Celess Sturgill, MD
• Heather Christine Stutzman, MA, BCBA
• Sarai Jocabed Suarez
• Phillip I. Subeck, LCSW
• Oriana Suh, D.M.D.
• Tyler William Sullivan, LMHCA
• Kyrsten Leeann Summa, FNP-BC
• Thomas L Summer, MD
• Summit Radiology Services LLC
• Sun Gate Dental

• Clinical Social Worker in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; 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.