KATHLEEN ANN SULLIVAN LICSW
NPI 1467574715
Social Worker - Clinical in Minneapolis, MN

Q: What is Kathleen Sullivan's NPI number?

The NPI number for Kathleen Sullivan is 1467574715. It was assigned to this individual provider in the NPPES registry on April 6, 2007.

Q: What is Kathleen Sullivan's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kathleen Sullivan was last updated on October 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.

Active since April 06, 2007PECOS Enrolled

621 W LAKE ST STE 350, MINNEAPOLIS, MN 55408(612) 979-2276(612) 925-0427 Get Directions Write a Review

NPPES record last updated: October 22, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 19, 2020, Oct 16, 2020 (2 updates tracked since 2020).

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About Kathleen Ann Sullivan Licsw NPPES

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

KATHLEEN ANN SULLIVAN LICSW (NPI 1467574715) is an individual clinical provider in Minneapolis, Minnesota, licensed in Minnesota (13480) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS, maintains a secondary practice location in Minneapolis, and is a graduate of Saint Louis University School Of Medicine (1995).

NPPES Registry Identity

NPI1467574715

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameKATHLEEN ANN SULLIVANCredential: LICSW

Location Address621 W LAKE ST STE 350Minneapolis, MN 55408-2952

Mailing Address3211 14th Ave SMinneapolis, MN 55407-2205

Phone(612) 979-2276

Fax(612) 925-0427

Sole ProprietorNo

Medical School CMSSaint Louis University School Of MedicineGraduated 1995

Enumeration DateApril 6, 2007

Last NPPES UpdateOctober 22, 20252 updates tracked since enumeration

NPPES CertifiedOctober 22, 2025

✔ NPI 1467574715 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 MN · 13480

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.

621 W LAKE ST STE 350, Minneapolis, MN 55408

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Secondary Practice Location 1

Location 13033 Excelsior Blvd Ste 215Minneapolis, MN 55416-5274 · Phone (612) 293-6523 · Fax (651) 925-0427

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kathleen Ann Sullivan Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3971931262

PECOS Enrollment IDI20200320000261

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 55408 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 $56.00 – $168.28

Typical copayment $0.00 (range $14.00 – $42.07)

Most-billed visit code NA

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

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.

LISA HOLLIDAY LICSW

Social Worker (Clinical)