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

MS. Jacquelyn Ruth Sullivan, LCSW

Individual provider Clinical Social Worker · NPI 1952406282

MS. Jacquelyn Ruth Sullivan, LCSW is a Clinical Social Worker in Sidney, New York. Qualified in 2001, 25 years ago. Accepts Medicare assignment. Licensed in New York.

Years since qualifying
25
Licensed in
NY
In the registry since
2006
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

76 Main St Ste B
Sidney, NY 13838
Phone: (607) 563-4080
Fax: (607) 336-7326
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 071014 (NY)

Record details

NPI number1952406282
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedSeptember 13, 2006
Last updated in NPPESJuly 27, 2011

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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