KELLY M SULLIVAN (NPI# 1962528778) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962528778 |
| Entity Type | Individual |
| Full Name | KELLY M SULLIVAN |
| Credential | LCSW |
| Practice Address |
1109 E Broadway St Cuero TX 77954-2108 |
| Practice Telephone | 3612752800 |
| Practice Fax Number | 3612758791 |
| Mailing Telephone | 3612752800 |
| Mailing Fax Number | 3612758791 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
50388 | TX | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | LIC. CLINICAL SOCIAL WORK | 50388 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144832205 | Kelly E Sullivan | Nurse Practitioner | 10020 Southern Maryland Blvd Ste 202, Dunkirk, MD 20754-3055 | 2020-08-20 |
| 1124670724 | Kelly Elizabeth Sullivan | Occupational Therapy Assistant | 12 Deforest Rd, Lansdowne, PA 19050-2109 | 2019-07-12 |
| 1427549088 | Kelly Elizabeth Sullivan | Nurse Practitioner | 428 Hartford Tpke Ste 207, Vernon, CT 06066-4841 | 2018-05-19 |
| 1134642267 | Kelly Glen Sullivan | Durable Medical Equipment & Medical Supplies | 3345 Seajay Dr, Beavercreek, OH 45430-1365 | 2017-07-20 |
| 1831636778 | Kelly Sullivan | Assistant Behavior Analyst | 273 Powell Cir, Berlin, MD 21811-1185 | 2017-01-30 |
| 1396197521 | Kelly Sullivan | Speech-Language Pathologist | 82 Ridgecrest Dr, Pittsburgh, PA 15235-4548 | 2016-07-12 |
| 1548657851 | Kelly Sullivan | Speech-Language Pathologist | 1021 Wind River Pkwy, Morrisville, NC 27560-8233 | 2015-04-24 |
| 1568867877 | Kelly Sullivan | Speech-Language Pathologist | 14105 Snow Rd, Brookpark, OH 44142-2557 | 2014-10-29 |
| 1053713024 | Kelly Goodrich Sullivan | Physical Therapist | 2035 Gayle Pl, Clearwater, FL 33763-4217 | 2014-09-22 |
| 1730595752 | Kelly Sullivan | Registered Nurse | 8 Jacqueline Ct, Port Jefferson Station, NY 11776-3117 | 2014-07-10 |
| Street Address |
1109 E BROADWAY ST |
| City | CUERO |
| State | TX |
| Zip Code | 77954-2108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689645376 | Parkside Family Clinic, Pa | Family Medicine | 1109 E Broadway St, Cuero, TX 77954-2108 | 2006-01-30 |
| 1285164749 | Hermelinda Fitts | Nurse Practitioner | 1109 E Broadway St, Cuero, TX 77954-2108 | 2017-06-18 |
| 1487009734 | Cody A Walthall | Family Medicine | 1109 E Broadway St, Cuero, TX 77954 | 2016-04-24 |
| 1659770030 | Dewitt Medical District | Family Medicine | 1109 E Broadway St, Cuero, TX 77954-2108 | 2014-08-21 |
| 1063793123 | Summer Laake | Nurse Practitioner | 1109 E Broadway St, Cuero, TX 77954-2108 | 2011-09-02 |
| 1922196393 | Troy W Lischka | Physician Assistant | 1109 E Broadway St, Cuero, TX 77954-2108 | 2006-10-11 |
| 1861595936 | Judith Ann Krupala | Nurse Practitioner | 1109 E Broadway St, Cuero, TX 77954-2108 | 2006-09-06 |
| 1700893484 | Herbert J Hall | Nurse Practitioner | 1109 E Broadway St, Cuero, TX 77954-2108 | 2006-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649658279 | H-e-b, Lp | Clinical Medical Laboratory | 909 E Broadway St, Cuero, TX 77954 | 2015-05-15 |
| 1558331421 | Dewitt Medical District | Home Health | 615 N Esplanade St, Cuero, TX 77954 | 2006-01-24 |
| 1922367366 | D Ross Braune Ma Lpc and Associates | Counselor | 401 Broadway Ave., 100, Cuero, TX 77954 | 2012-05-04 |
| 1053487868 | Dewitt Medical District | Nursing Care | 615 N Esplanade St, Cuero, TX 77954 | 2006-11-27 |
| 1770699027 | Cuero Medical Associates Pa | Family Medicine | 2500 N Esplanade, Suite 102, Cuero, TX 77954 | 2006-08-21 |
| 1710202098 | David Ronald Polasek | Pharmacist | 515 N Esplanade, Cuero, TX 77954-0270 | 2010-03-30 |
| 1124284500 | Renal Treatment Centers Southeast Lp | Clinic/Center | 1105 E Broadway St, Cuero, TX 77954-2108 | 2008-08-05 |
| 1104843382 | Wal-mart Stores Texas LLC | Durable Medical Equipment & Medical Supplies | 1202 E Broadway St, Cuero, TX 77954-2124 | 2006-07-16 |
| 1376082396 | Kevin Ferrall | Pharmacist | 909 E Broadway St, Cuero, TX 77954-2126 | 2017-02-23 |
| 1104953215 | Dewitt-lavaca Special Education Cooperative | Counselor | 960 E Broadway St, Cuero, TX 77954-2131 | 2007-02-27 |
| Find all providers in zip 77954 | ||||
| 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 |
|---|---|---|---|---|
| 1437750189 | Nikkie Alan Rice | Social Worker | 6034 Laguna Vista Dr, El Paso, TX 79932-4109 | 2020-11-07 |
| 1194326926 | Janai June Bryan | Social Worker | 2312 Western Trails Blvd Ste B204, Austin, TX 78745-1677 | 2020-11-06 |
| 1942801337 | Dynamik Transformations, LLC | Social Worker | 3522 Duncaster Dr, Missouri City, TX 77459 | 2020-11-03 |
| 1700487071 | Amanda Paige Kendig | Social Worker | 5000 Riverside Dr Bldg 6, Ste 100e, Irving, TX 75039-4316 | 2020-11-03 |
| 1639779333 | Caitlyn Ussery | Social Worker | 5806 Terra Dr, Arlington, TX 76017-4216 | 2020-10-30 |
| 1528668324 | Paragon Counseling and Consulting | Social Worker | 2919 Driftwood Bend Dr, Fresno, TX 77545-6113 | 2020-10-30 |
| 1336749654 | Rachael E Swearingin | Social Worker | 108 Meadowbend Dr, Cedar Hill, TX 75104-3278 | 2020-10-27 |
| 1336749563 | Kelly Jo Rolland | Social Worker | 2904 4th St Ste 102, Longview, TX 75605-5124 | 2020-10-27 |
| 1083214415 | Barbara Jefferson | Social Worker | 1110 Brown Dr, Pflugerville, TX 78660-4908 | 2020-10-26 |
| 1285234716 | Leah Mcnulty | Social Worker | 13722 Office Park Dr Ste B, Houston, TX 77070-2891 | 2020-10-26 |
| Find all providers with the same taxonomy | ||||
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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.