MELINDA JEAN SULLIVAN (LCSW LADC) – Clinical Social Worker, NPI 1295925485

MELINDA JEAN SULLIVAN (LCSW LADC) is a healthcare provider. based in West hartford, Connecticut. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW LADC. They hold a License No. 006460 (CT). The NPI Number for MELINDA JEAN SULLIVAN (LCSW LADC) is 1295925485

Main info

Female
Sole Proprietor
21 Years Of Experience
Name
MELINDA JEAN SULLIVAN (LCSW LADC)
NPI
1295925485
Phone
(860) 559-6922
Address
97 SOUTH ST STE 105
Enumeration Date
25 July 2007
Last Update Date
22 March 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8602812280
Graduation Year
2005 (21 years ago)
PAC ID
7618063710
Group Practice PAC ID
0941683056
Professional Enrollment ID
I20071022000160
Address ID
CT060107404BR123XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness75
Years active:18State licenses:1Digital endpointsOther names

2,151 CLINICAL SOCIAL WORKER in CT

Provider Addresses for MELINDA JEAN SULLIVAN (LCSW LADC)

  • 97 SOUTH ST STE 105

    WEST HARTFORD, CT 061101964

    Phone: (860) 559-6922

    Type: Mailing

  • 91, Bellevue Avenue, Federal Hill Historic District, Bristol, Hartford County, Connecticut, 06010, United States

    BRISTOL, CT 060105817

    Phone: (860) 559-6922

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-10-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20071022000160IClinical Social WorkerCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06110)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0941683056View full group profile
NameSpecialtyState
Clinical Social WorkerCT
Marriage And Family TherapistCT
Mental Health CounselorCT
Clinical Social WorkerCT
Clinical Social WorkerCT
Nurse PractitionerCT
Marriage And Family TherapistCT
Marriage And Family TherapistCT
Marriage And Family TherapistCT
Clinical Social WorkerCT

Reviews

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Frequently asked questions

What number should I use to identify MELINDA JEAN SULLIVAN (LCSW LADC) for billing?
Administrative and clinical systems typically use NPI 1295925485 for MELINDA JEAN SULLIVAN (LCSW LADC).
Is MELINDA JEAN SULLIVAN (LCSW LADC)'s NPI status active today?
Active status means MELINDA JEAN SULLIVAN (LCSW LADC)'s NPI record is not deactivated in the public file.
What services align with MELINDA JEAN SULLIVAN (LCSW LADC)'s listing?
MELINDA JEAN SULLIVAN (LCSW LADC)'s public classification highlights Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is MELINDA JEAN SULLIVAN (LCSW LADC) tied to West Hartford, Connecticut?
If you are local to West Hartford, Connecticut, MELINDA JEAN SULLIVAN (LCSW LADC) may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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