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LISA SULLIVAN LCSW
NPI 1336486414
Social Worker - Clinical in Medford, NY

Active since January 10, 2013PECOS Enrolled
31 INDUSTRIAL BLVD, MEDFORD, NY 11763(631) 205-6232(631) 924-4454 Get Directions Write a Review

NPPES record last updated: January 25, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lisa Sullivan Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LISA SULLIVAN LCSW (NPI 1336486414) is an individual clinical provider in Medford, New York, licensed in New York (083436-1) and active in the NPI registry since January 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336486414
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameLISA SULLIVANCredential: LCSW
Location Address31 INDUSTRIAL BLVDMedford, NY 11763-2220
Mailing Address31 Industrial BlvdMedford, NY 11763-2220 · (631) 205-6232 · Fax (631) 924-4454
Phone(631) 205-6232
Fax(631) 924-4454
Sole ProprietorYes
Enumeration DateJanuary 10, 2013
Last NPPES UpdateJanuary 25, 2022
NPPES CertifiedJanuary 25, 2022
✔ NPI 1336486414 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in NY · 083436-1
Definition
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.
31 INDUSTRIAL BLVD, Medford, NY 11763
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lisa Sullivan Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11763 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $67.40 – $203.53
Typical copayment $0.00 (range $16.85 – $50.88)
Most-billed visit code NA
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OLUMIDE OYELEYE
Nurse Practitioner (Psychiatric/Mental Health)
31 INDUSTRIAL BLVD
MEDFORD, NY 11763
Suffolk County (631) 924-4411
MADELINE SEMA MAXWELL LMSW
Social Worker
31 INDUSTRIAL BLVD
MEDFORD, NY 11763
Suffolk County (631) 205-6402
JANICE GALLAGHER RN
Registered Nurse (Psychiatric/Mental Health, Adult)
31 INDUSTRIAL BLVD
MEDFORD, NY 11763
Suffolk County (631) 924-4411
KAITLIN G FIBKINS LCSW
Social Worker (Clinical)
31 INDUSTRIAL BLVD
MEDFORD, NY 11763
Suffolk County (631) 924-4411
EDWARD BROWNWORTH
Licensed Practical Nurse
31 INDUSTRIAL BLVD
MEDFORD, NY 11763
Suffolk County (631) 924-4411
ANGELA TRINGONE LCSW
Social Worker (Clinical)
31 INDUSTRIAL BLVD
MEDFORD, NY 11763
Suffolk County (631) 924-4411
SHARON ACOSTA LCSW
Social Worker (Clinical)
31 INDUSTRIAL BLVD
MEDFORD, NY 11763
Suffolk County (631) 924-4411
TRACY A. CULLEN LCSW
Social Worker (Clinical)
31 INDUSTRIAL BLVD
MEDFORD, NY 11763
Suffolk County (631) 924-4411

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 Lisa Sullivan's NPI number?

The NPI number for Lisa Sullivan is 1336486414. It was assigned to this individual provider in the NPPES registry on January 10, 2013.

Where is Lisa Sullivan located?

Lisa Sullivan practices at 31 Industrial Blvd, Medford, NY 11763. The listed phone number is (631) 205-6232.

What is Lisa Sullivan's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Lisa Sullivan enrolled in Medicare?

Yes. Lisa Sullivan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Lisa Sullivan was last updated on January 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.