Amanda Kate Sullivan

Primary specialty

Social WorkerTaxonomy code 104100000X

License

MSW.006749 Issued in CT

Practice address

345 N Main St Ste 317
West Hartford, CT 06117-2508

Phone

(860) 937-3875

NPI assigned

Sep 17, 2019

Last updated

Jun 24, 2024By the provider in NPPES

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

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Inner Wellness Counseling Group LLCGroup PAC ID 3375933658, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda.sullivan.p1@direct.wheelerclinic.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Inner Wellness Counseling Group, LLC

  • Clinical Social Worker
  • Cromwell, CT
  • NPI 1336642008
  Medicare reassignment Care Compare group NPD
• Jane R. Cooper Counseling & Psychotherapy, PLLC

  • Professional Counselor
  • Glastonbury, CT
  • NPI 1346095007
  NPD (past)
• Pinnacle Behavioral Health, PC

  • Child & Adolescent Psychiatry Physician
  • West Hartford, CT
  • NPI 1932678919
  NPD (past)

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1851941280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 LAUREL DR",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061101737",
            "telephone_number": "860-256-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 N MAIN ST STE 317",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172508",
            "telephone_number": "860-937-3875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "AMANDA",
        "middle_name": "KATE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-17",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "MSW.006749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suburban Home Medical, Inc
• Suburban Pharma Inc (Suburban Pharmacy)
• Suburban Pharma Inc (Suburban Pharmacy)
• Suburban Pharmacy LTC Inc
• Leonard C Suchotliff, PHD
• Emily Sullivan
• Emily Ricker Sullivan, M ED., BCBA
• Sullivan, Lemay & Associates Behavioral Health & Wellness LLC
• Melinda Jean Sullivan, LCSW LADC
• Paul Ryan Charles Sullivan, MD

• Social Worker in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.