MICHELLE P SULLIVAN LCSW NPI 1134110760

NPI Information

  • NPI: 1134110760
  • Provider Name: MICHELLE P SULLIVAN, LCSW
  • Classification: Social Worker - 104100000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4700 NORTH LAS VEGAS BOULEVARD
    MIKE O'CALLAGHAN FEDERAL MEDICAL CENTER
    NELLIS AIR FORCE BASE, NV
    ZIP 89191
  • Phone: (702) 653-3455

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NPI Details

Michelle P Sullivan, LCSW is a social worker in Nellis Air Force Base, NV. The provider is a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. Michelle P Sullivan, LCSW NPI is 1134110760. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4700 NORTH LAS VEGAS BOULEVARD
MIKE O'CALLAGHAN FEDERAL MEDICAL CENTER
NELLIS AIR FORCE BASE, NV
ZIP 89191-601
Phone: (702) 653-3455
Fax: (702) 653-3398

The NPI 1134110760 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 11/2/2005 and was last updated on 3/10/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1104100000XSocial WorkerCW014390PENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1028024MEDICARE ID-TYPE UNSPECIFIEDPENNSYLVANIA
2SU 763420OTHERPENNSYLVANIAHIGHMARK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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