MR. MARK ANDREW SULLIVAN (NPI# 1790813509) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790813509 |
| Entity Type | Individual |
| Full Name | MR. MARK ANDREW SULLIVAN |
| Credential | LICSW |
| Practice Address |
111 Torrey St Brockton MA 02301-4800 |
| Mailing Address |
179 Depot St South Easton MA 02375 |
| Practice Telephone | 5085845190 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
1020933 | MA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689730863 | Mark Allan Sullivan | Chiropractor | 4196 Avery Rd, Hilliard, OH 43026-1004 | 2006-12-29 |
| 1356456297 | Mark Tighe Sullivan | Social Worker | 1011 Bond St, Asbury Park, NJ 07712-5939 | 2006-08-20 |
| 1306874227 | Mark Allen Sullivan | Physical Therapist | 133 Mountain Rd, Suite 2b., Suffield, CT 06078-2084 | 2006-06-29 |
| 1497722615 | Mark F Sullivan Sr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11236 Robinwood Dr, # 7, Hagerstown, MD 21742-6708 | 2006-03-07 |
| 1710983432 | Mark P. Sullivan | Dentist | 1440 South Pottstown Pike, West Chester, PA 19380-1271 | 2005-06-27 |
| 1134752371 | Mark Sullivan | Nurse Anesthetist, Certified Registered | 2500 N State St, Jackson, MS 39216-4500 | 2020-02-17 |
| 1295260347 | Mark Sullivan | Case Manager/Care Coordinator | 1015 Lanton Rd, West Plains, MO 65775-3854 | 2017-04-26 |
| 1841724754 | Mark Sullivan | Social Worker | 2670 Durham Chapel Hill Blvd, Durham, NC 27707-2829 | 2017-04-18 |
| 1386098762 | Mark Sullivan | Psychiatry & Neurology | 525 E 68th St, New York, NY 10065-4870 | 2016-04-21 |
| 1346614641 | Mark Sullivan | Social Worker | 5225 Connecticut Ave Nw, #616, Washington, DC 20015-1813 | 2015-11-24 |
| Street Address |
111 TORREY ST |
| City | BROCKTON |
| State | MA |
| Zip Code | 02301-4800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083665186 | Michael D Keefe | Dentist | 111 Torrey St, Brockton, MA 02301-4800 | 2006-05-13 |
| 1437691755 | Joan Burke | Counselor | 111 Torrey St, Brockton, MA 02301-4800 | 2016-11-17 |
| 1407235476 | Cassandra Schmall | Student in an Organized Health Care Education/Training Program | 111 Torrey St, #3, Brockton, MA 02301-4800 | 2015-05-24 |
| 1962816496 | Ericka Rogers | Student in an Organized Health Care Education/Training Program | 111 Torrey St, Brockton, MA 02301-4800 | 2014-06-12 |
| 1558636373 | Jennifer Hall Difalco | Family Medicine | 111 Torrey St, Brockton, MA 02301-4800 | 2012-03-12 |
| 1396017059 | Stephen Fearnley | Counselor | 111 Torrey St, Suite 3, Brockton, MA 02301-4800 | 2012-01-27 |
| 1861607558 | Bethel Medical Group PC | Family Medicine | 111 Torrey St, Brockton, MA 02301-4800 | 2007-05-14 |
| 1942331665 | Janis Shakr | Family Medicine | 111 Torrey St, Brockton, MA 02301-4800 | 2007-03-07 |
| 1053454272 | Jessica Chang Lim | Family Medicine | 111 Torrey St, Brockton, MA 02301-4800 | 2007-02-15 |
| 1871646448 | Rhonda Lee Gately | Nurse Practitioner | 111 Torrey St, Brockton, MA 02301-4800 | 2007-01-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807110 | Jenny Vulpis | Recreation Therapist | 940 Belmont St (br 135), Brockton, MA 02301 | 2020-10-01 |
| 1205444924 | Caroline Storey | Counselor | Men's Addiction Treatment Center, 10 Meadowbrook Road, Brockton, MA 02301 | 2020-07-20 |
| 1013546852 | Nuria Dos Santos Veiga | Occupational Therapist | 73 Denton St, Brockton, MA 02301 | 2020-04-03 |
| 1679113930 | Laura Ann Brondyk II | Counselor | 10 Christys Dr, Brockton, MA 02301 | 2020-01-14 |
| 1437796521 | Andrea Lopes | Developmental Therapist | 7 Goddard Road, Brockton, MA 02301 | 2019-12-08 |
| 1518420124 | Diligencehealthcare | Psychiatry & Neurology | 30-40 Westpark Street, Brockton, MA 02301 | 2019-04-10 |
| 1124530373 | Rachel Theys | Behavioral Analyst | 130 Liberty St Ste 13a, Brockton, MA 02301 | 2017-10-27 |
| 1689193369 | Anderson D Delgado | Behavior Technician | 11 Packard Way, Brockton, MA 02301 | 2017-09-14 |
| 1811415326 | Francesca Lavecchia | Clinical Neuropsychologist | Brockto Area Multi Service, Inc. 10 Christy Dr., Brockton, MA 02301 | 2017-09-05 |
| 1831615343 | Donna Marie Dugan | Counselor | South Bay Community Services, 340 Main Street - Suite 818, Worcester, MA 02301 | 2017-08-16 |
| Find all providers in zip 02301 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003414335 | Trinette Stephenson Hall | Social Worker | 29 Belcher Ave, Brockton, MA 02301-4103 | 2020-10-09 |
| 1700349305 | Carolyn M Mccrosson | Social Worker | 147 Centre St Apt 609, Brockton, MA 02302-2777 | 2019-04-10 |
| 1134681109 | Malaka Mims | Social Worker | 55 Perry Ave, Brockton, MA 02302-3606 | 2019-04-01 |
| 1609331131 | Therapie LLC | Social Worker | 425 Pleasant 9t., Brockton, MA 02301-2535 | 2019-02-08 |
| 1427513373 | Miriam Monteiro | Social Worker | 688 Plain Street, Brockton, MA 02302 | 2019-02-05 |
| 1619432523 | Shirley Elefson | Social Worker | 330 Crescent Street, Brockton, MA 02302 | 2019-02-05 |
| 1073098059 | Deborah M Rose | Social Worker | 20 Cerel Cir, Brockton, MA 02302-1929 | 2018-09-26 |
| 1811472772 | Cathleen Ann Saunders | Social Worker | 232 Bates Rd, Brockton, MA 02302-3013 | 2018-09-26 |
| 1760964043 | Anna Daniels | Social Worker | 235 N Pearl St Unit 4b, Brockton, MA 02301-1794 | 2018-09-03 |
| 1033690607 | Beverly Ruth Hubler | Social Worker | 567 Pleasant St Ste 101, Brockton, MA 02301-2507 | 2018-08-22 |
| Find all providers in BROCKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.