Kimberly Sullivan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3275 Issued in KY

Practice address

3121 Brooklawn Campus Dr
Louisville, KY 40218-1282

Phone

(502) 451-5177

Fax

(502) 575-0464

NPI assigned

Jan 27, 2014

Sex

Female

Sole proprietor

Yes

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

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.

• Louisville Mental Health Group

  • Clinical Social Worker
  • Louisville, KY
  • NPI 1386140358
  NPD Authorized official

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

{
    "created_epoch": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390780800000",
    "number": "1750704789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 BROOKLAWN CAMPUS DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402181282",
            "telephone_number": "502-451-5177",
            "fax_number": "502-575-0464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 BROOKLAWN CAMPUS DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402181282",
            "telephone_number": "502-451-5177",
            "fax_number": "502-575-0464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KIMBERLY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-27",
        "last_updated": "2014-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joeli Rae Sullivan
• John F. Sullivan, MD
• John Paul Sullivan, M.D.
• Kaitlin Sullivan, PA-C
• Kelly G Sullivan
• Mark F Sullivan, OD
• Meghan Sullivan, APRN
• Melissa Sullivan, MD
• Misty Sullivan, M.ED
• Richalle Victoria Smith Sullivan, MD

• Clinical Social Worker in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.