Patricia Sullivan Jane Sullivan, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1025888 Issued in MA

Practice address

456 Rock St
Fall River, MA 02720-3343

Phone

(508) 789-1194

Fax

(508) 672-0450

NPI assigned

Nov 20, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Behavioral Psychiatric & Psychological Associates, P.C.

  • Mental Health Counselor
  • Raynham, MA
  • NPI 1578674032
  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370563200000",
    "number": "1831263847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 ROCK ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027203343",
            "telephone_number": "508-789-1194",
            "fax_number": "508-672-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 ROCK ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027203343",
            "telephone_number": "508-789-1194",
            "fax_number": "508-672-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "PATRICIA SULLIVAN",
        "middle_name": "JANE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2013-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "975",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1025888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1859218",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suite Life Medical PC
• Carolyn Shannon Sullivan, LIC. AC
• Karen Schneider Sullivan, MS-CCC-SLP
• Laura D Sullivan, CRNA
• Maryann Sullivan, CADAC
• Taylor Sullivan
• Adnan Sultan, MD
• Sunbridge Healthcare Corporation
• Shobhita Sundar, MD
• Sunny Smile IV Inc

• Clinical Social Worker in Fall River, MA
• Providers in Fall River, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2013; 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.