MR. C STAN SULLIVAN (LCSW) – Clinical Social Worker, NPI 1407129588

Excluded from federal healthcare programs (Medicare/Medicaid)

This provider is listed on the OIG List of Excluded Individuals/Entities (LEIE). Exclusion effective: 2024-11-20. Reason: License revocation, suspension, or surrender.

Clinical Social Worker

MR. C STAN SULLIVAN (LCSW) is a healthcare provider. based in St george, Utah. specializing in Clinical Social Worker. They hold the professional credentials LCSW. They hold a License No. 130803-3501 (UT). The NPI Number for MR. C STAN SULLIVAN (LCSW) is 1407129588

Main info

Male

Sole Proprietor

43 Years Of Experience

Accepts Medicare Assignment

Name

MR. C STAN SULLIVAN (LCSW)

NPI

1407129588

Phone

(435) 862-8273

Address

377 E Riverside Dr Ste B

Enumeration Date

20 February 2012

Last Update Date

22 May 2019

Doctor Profile

Medical School Name

OTHER

Secondary Phone

4358628273

Graduation Year

1983 (43 years ago)

PAC ID

3375877947

Group Practice PAC ID

3173882065

Professional Enrollment ID

I20190702000959

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience42

Completeness75

Years active:14State licenses:1Digital endpointsOther names

Provider Addresses for MR. C STAN SULLIVAN (LCSW)

377 E Riverside Dr Ste B
St George, UT 84790
Phone: (435) 862-8273
Fax: (435) 275-4256
Type: Location
377 E RIVERSIDE DR STE B
ST GEORGE, UT 847904749
Phone: (435) 862-8273
Fax: (435) 275-4256
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.

No Medicare enrollment or revalidation data available for this provider in our database.

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 84790)

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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: 3173882065View full group profile

Name	Specialty	State
MCKENZIE MORGAN (LCSW)	Clinical Social Worker	UT
LEE WULFENSTEIN	Marriage And Family Therapist	UT
LORNETA HALL FERGUSON (LCSW)	-	UT
DAKOTA JACK CALLAHAN (CSW, MSW)	Clinical Social Worker	UT
ALLYSON HOLT (LCSW)	Clinical Social Worker	UT
DR. MICKEY JOE FULLER (MA, MS, PSY.D.)	Clinical Psychologist	UT
MR. MATT BULKLEY (LCSW)	Clinical Social Worker	UT
BRENDA W HECK	Clinical Social Worker	UT
MICHAEL BEACCO (LCSW)	Clinical Social Worker	UT
MRS. KENA MARIN FREY (LCSW)	-	UT

Reviews

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Frequently asked questions

What unique ID ties claims to MR. C STAN SULLIVAN (LCSW)?

NPI 1407129588 is assigned to MR. C STAN SULLIVAN (LCSW) under the national enumeration system.

Does this profile mean MR. C STAN SULLIVAN (LCSW) is currently active?

Yes — MR. C STAN SULLIVAN (LCSW) appears active in the national provider directory.

What does MR. C STAN SULLIVAN (LCSW) treat or focus on?

Patients typically see MR. C STAN SULLIVAN (LCSW) under the specialty Clinical Social Worker. Clinical services aligned with this taxonomy classification.

Does MR. C STAN SULLIVAN (LCSW) practice in Utah?

You will see St George, Utah on file for MR. C STAN SULLIVAN (LCSW) alongside any extra practice locations.

How can I contact MR. C STAN SULLIVAN (LCSW)?

Phone or fax may appear on the official NPI record when supplied — verify before relying on them.