Active NPI
Heather Sullivan, LCSW
- Clinical Social Worker
- Alexandria, VA
National Provider Identifier
1801653506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904015926
- Practice address
- 901 N Washington St Ste 206
Alexandria, VA 22314-1535 - Phone
- (202) 412-9672
- NPI assigned
- Feb 29, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 25414 | MD | |
| Clinical Social Worker | 1041C0700X | 0904015926 | VA | Primary |
Addresses
Primary practice location
901 N Washington St Ste 206
Alexandria, VA 22314-1535
Mailing address
901 N Washington St Ste 206
Alexandria, VA 22314-1535
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 29, 2024 through Apr 29, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25414 | MD | MD | Clinical Social Worker |
| 0904015926 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709164800000",
"number": "1801653506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 N WASHINGTON ST STE 206",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223141535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 N WASHINGTON ST STE 206",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223141535",
"telephone_number": "202-412-9672"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "HEATHER",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-29",
"last_updated": "2024-02-29",
"certification_date": "2024-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "25414",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904015926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.