Laura Sullivan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

79901 Issued in CA

Practice address

140 Gibson St
Ukiah, CA 95482

Phone

(707) 468-5536

NPI assigned

Jul 14, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1972910750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 E GOBBI ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954825511",
            "telephone_number": "707-467-2010",
            "fax_number": "707-462-6994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 GIBSON ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "95482",
            "telephone_number": "707-468-5536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 E Gobbi St",
            "address_purpose": "LOCATION",
            "city": "Ukiah",
            "state": "CA",
            "postal_code": "954825511",
            "country_code": "US",
            "telephone_number": "707-467-2010",
            "fax_number": "707-462-6994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LAURA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "79901",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "79901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Streufert
• Linda Strong
• Emma Stuart
• Marcella Evelyn Studebaker
• Jacob Stults, DO
• Margaret Meave Johnson Sullivan, ACSW
• Joshua Summit
• Alan C Sunbeam, L. AC.
• Nancy Sutherland
• Elizabeth Anne Sutter, SUDRC 16007

• Clinical Social Worker in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; 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.