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NPI Code Detail

MEDICARE: ANNA C SULLIVAN LCSW

MEDICARE: ANNA C SULLIVAN LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker0904013003VA
21041C0700XClinical Social Worker

General Provider Information

NPI Number : 1588336515
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA C SULLIVAN LCSW
Provider Business Mailing Address
First Line : 13135 ROUTE 50 STE 300
Second Line :
City : FAIRFAX
State : VA
Zip : 22033-1907
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 13135 ROUTE 50 STE 300
Second Line :
City : FAIRFAX
State : VA
Zip : 22033-1907
Country : US
Telephone Number : 703-322-0241
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2021
Last Update Date : 03/05/2026

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Directions to “ ANNA C SULLIVAN LCSW” Practice Location

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