Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Alexander Blake Sullivan, LCSW, LICSW, LIMHP

Individual provider Clinical Social Worker · NPI 1922622042

Alexander Blake Sullivan, LCSW, LICSW, LIMHP is a Clinical Social Worker in Roseville, Minnesota. Graduated from Florida State University College of Medicine in 2017, 9 years ago. Works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Arizona, Colorado, Florida and Minnesota and 4 more.

Years since qualifying
9
Trained at
Florida State University College of Medicine
Licensed in
AZ, CO, FL, MN, NE, NV
In the registry since
2020
Specialties on file
8
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

2786 Fairview Ave N Ste 38
Roseville, MN 55113-1306
Phone: (763) 412-1993
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 2420 Cleveland Ave N, Roseville, MN 55113-2727 — (952) 900-2749
  • 2136 Ford Pkwy # 5429, Saint Paul, MN 55116-2850 — (952) 900-2749

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 30850 (MN)
Clinical Social Worker Taxonomy 1041C0700X · Licence 3594 (NE)
Clinical Social Worker Taxonomy 1041C0700X · Licence CSW.09929192 (CO)
Clinical Social Worker Taxonomy 1041C0700X · Licence 11498-C (NV)
Clinical Social Worker Taxonomy 1041C0700X · Licence SW16639 (FL)
Clinical Social Worker Taxonomy 1041C0700X · Licence 13344228-3501 (UT)
Clinical Social Worker Taxonomy 1041C0700X · Licence LW61539336 (WA)
Clinical Social Worker Taxonomy 1041C0700X · Licence 21854 (AZ)

Record details

NPI number1922622042
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW , LICSW , LIMHP
Sole proprietorNo
NPI enumeratedJune 4, 2020
Last updated in NPPESFebruary 6, 2025
Certification dateFebruary 6, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolFLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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