MR. DANIEL T SULLIVAN (LICSW) – Clinical Social Worker, NPI 1124235734

MR. DANIEL T SULLIVAN (LICSW) is a healthcare provider. based in South boston, Massachusetts. specializing in Clinical Social Worker. They hold the professional credentials LICSW. They hold a License No. 115114 (MA). The NPI Number for MR. DANIEL T SULLIVAN (LICSW) is 1124235734

Main info

Male
20 Years Of Experience
Name
MR. DANIEL T SULLIVAN (LICSW)
NPI
1124235734
Phone
(617) 268-1700
Address
58 OLD COLONY AVE
Enumeration Date
16 May 2007
Last Update Date
7 June 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6176364800
Graduation Year
2006 (20 years ago)
PAC ID
8729266036
Group Practice PAC ID
3274442223
Professional Enrollment ID
I20110708000246
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for MR. DANIEL T SULLIVAN (LICSW)

  • 58, Old Colony Avenue, South Boston, Boston, Suffolk County, Massachusetts, 02127, United States

    SOUTH BOSTON, MA 021272406

    Phone: (617) 268-1700

    Fax: (617) 268-1991

    Mailing address matches the actual address.

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: 2011-07-08

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
I20110708000246IClinical Social WorkerMATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90834Psychotherapy, 45 minutes6211$0
View full utilization report →

Insurance plans in this area (ZIP 02127)

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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: 3274442223View full group profile

Reviews

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Frequently asked questions

Can I use this page to confirm MR. DANIEL T SULLIVAN (LICSW)'s NPI?
Yes. MR. DANIEL T SULLIVAN (LICSW) is listed with NPI 1124235734 in the public NPI dataset.
Is MR. DANIEL T SULLIVAN (LICSW) listed as active for patients and plans?
The listing shows MR. DANIEL T SULLIVAN (LICSW) as active in the NPI system.
What is MR. DANIEL T SULLIVAN (LICSW)'s specialty?
The listing groups MR. DANIEL T SULLIVAN (LICSW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where is MR. DANIEL T SULLIVAN (LICSW) based?
MR. DANIEL T SULLIVAN (LICSW) is tied to South Boston, Massachusetts in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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