JOHN SULLIVAN LCSW
NPI 1275249112
Counselor - Professional in Mcdonough, GA
About John Sullivan Lcsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JOHN SULLIVAN LCSW (NPI 1275249112) is an individual professional provider in Mcdonough, Georgia, licensed in Georgia (LPC013465) and active in the NPI registry since January 2023. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
John Sullivan Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show John Sullivan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Mcdonough, GA 30253
- Reassigned Medicare billing, Georgia enrollment
- 2 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MCDONOUGH, GA 30253
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is John Sullivan's NPI number?
The NPI number for John Sullivan is 1275249112. It was assigned to this individual provider in the NPPES registry on January 24, 2023.
Where is John Sullivan located?
John Sullivan practices at 901 Pavilion Ct, Mcdonough, GA 30253. The listed phone number is (678) 814-4375.
What is John Sullivan's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is John Sullivan enrolled in Medicare?
Yes. John Sullivan is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for John Sullivan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), John Sullivan reassigns Medicare benefits to Mindful Realizations Counseling & Consulting LLC (Mcdonough, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for John Sullivan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does John Sullivan accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list John Sullivan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for John Sullivan was last updated on January 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# John Sullivan, LCSW · NPI 1275249112
Professional provider in Mcdonough, Georgia. Individual provider, active in the CMS NPPES registry since January 24, 2023.
## Identity
- **NPI:** 1275249112 (Entity type: Individual)
- **Enumerated:** January 24, 2023
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** LPC013465 (Georgia)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 901 PAVILION CT, Mcdonough, GA 30253-6665
- **Phone:** (678) 814-4375
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Mindful Realizations Counseling & Consulting LLC (NPI 1295164549, Mcdonough, GA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 24, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1275249112) · Data from the CMS NPPES public registry.