Timothy Sullivan, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1025742 Issued in MA

Practice address

6 Pleasant St
6TH Floor
Malden, MA 02148-5100

Phone

(781) 871-6550

NPI assigned

Apr 6, 2007

Sex

Male

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 MA

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

Boston University School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nova Psychiatric Services, P.CGroup PAC ID 4183524887, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nova Psychiatric Services, PC

  • Community/Behavioral Health Agency
  • Quincy, MA
  • NPI 1881782522
  Medicare reassignment Care Compare group NPD
• Nova Psychiatric Service

  • Psychologist
  • Quincy, MA
  • NPI 1598838781
  NPD (past)

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992827026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490323",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021490005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 PLEASANT ST",
            "address_2": "6TH FLOOR",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485100",
            "telephone_number": "781-871-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "TIMOTHY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1025742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Su, DMD
• Subhash C Bowry MD PC
• James Patrick Sullivan, MD
• Laura J Sullivan, MD
• Thomas S Sullivan, DC
• Supportive Care
• Joseph W Surette, D.C.
• Jill E Swartz, M.D.
• Alison Swiatocha
• Emily Sy, NP

• Clinical Social Worker in Malden, MA
• Providers in Malden, 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 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.
• 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.