Active NPI
Ann M Sullivan, LCSW
- Clinical Social Worker
- Bangor, ME
National Provider Identifier
1932270329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC3436
- Practice address
- 96 Harlow St
Box 225
Bangor, ME 04401-4925 - Phone
- (207) 735-8410
- NPI assigned
- Nov 10, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC3436 | ME | Primary |
Addresses
Primary practice location
96 Harlow St
Box 225
Bangor, ME 04401-4925
Mailing address
96 Harlow St
Box 225
Bangor, ME 04401-4925
Phone (207) 735-8410
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC3436 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1932270329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "96 HARLOW ST",
"address_2": "BOX 225",
"city": "BANGOR",
"state": "ME",
"postal_code": "044014925",
"telephone_number": "207-735-8410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "96 HARLOW ST",
"address_2": "BOX 225",
"city": "BANGOR",
"state": "ME",
"postal_code": "044014925",
"telephone_number": "207-735-8410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "ANN",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC3436",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bangor, ME
- Rafal Subernat, D.O.
- Carla Jessica Sueldo Feijoo, M.D.
- Riim Aweis Suja, AGACNP-BC
- Richard Adam Sukiennik, DPT
- Ella J Sulinski, LMSW-CC
- Malachy J Sullivan, M.D.
- Sunbury Primary Care
- Sunbury Primary Care, P.a. (Sunbury Physical and Occupational Therapy)
- Sunbury Primary Care, P.a. (HealthWORKS Occupational & Sports Medicine)
- Sunbury Primary Care, P.a. (Sunbury Medical Assocaites)
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.