Susan Bridget Sullivan, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C004086 Issued in NC

Practice address

400 Commerce Ave
Suite a
Morehead City, NC 28557-3421

Phone

(252) 422-1655

NPI assigned

Jun 30, 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 7, 2017 through Dec 7, 2027

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.

• Barton L Lewis MD

  • Psychiatry Physician
  • Morehead City, NC
  • NPI 1720371081
  NPD (past)

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881622306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 OAK DR",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285576265",
            "telephone_number": "252-422-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 COMMERCE AVE",
            "address_2": "SUITE A",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285573421",
            "telephone_number": "252-422-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SUSAN",
        "middle_name": "BRIDGET",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106063",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1400A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelley B Sturm, CRNA
• Amanda Christine Styron, LCMHC-S LCAS CCS
• Kelly Wayne Styron, DPT
• Kennedy Nicole Sullivan, RDN
• Lori McCoy Sullivan, PT
• Sunrise Pediatrics PLLC
• Kathryn Suralik, LMBT, NCBTMB
• Ashley Noel Susen, DPT
• Brandon Bain Sutton, LMBT
• Nathan Erich Swacha, DC

• Clinical Social Worker in Morehead City, NC
• Providers in Morehead City, NC by specialty
• Clinical Social Worker in North Carolina

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.