Sandra Sully I, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS10262 Issued in CA

Practice address

256 S Robertson Blvd
797
Beverly Hills, CA 90211-2811

Phone

(626) 578-0419

NPI assigned

Nov 3, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750460499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 E COMPTON BLVD",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902213303",
            "telephone_number": "310-668-6857",
            "fax_number": "310-898-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 S ROBERTSON BLVD",
            "address_2": "797",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112811",
            "telephone_number": "626-578-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLY",
        "first_name": "SANDRA",
        "name_suffix": "I",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS10262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cho Chun Su, AMFT
• Susan Meifang Su I, LAC.
• Edwin A Suddleson, M.D.
• Joseph Harry Sugerman, M.D.
• Sukrant Mehta, MD PC
• Amit Kartar Singh Sumal, MD
• Sumeet Wadhwani MD Inc
• Summit Surgical Associates LLC
• Sun Therapeutics, a Professional Acupuncture & Integrative Medicine Co
• Danling Sun, L.AC

• Clinical Social Worker in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Clinical Social Worker in California

• 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.

Verify at the official NPI Registry.