Alexander Blake Sullivan, LCSW, LICSW, LIMHP in Roseville, MN

Alexander Blake Sullivan, LCSW, LICSW, LIMHP is a medicare enrolled "Social Worker - Clinical" provider in Roseville, Minnesota. His current practice location is 2786 Fairview Ave N Ste 38, Roseville, Minnesota. You can reach out to his office (for appointments etc.) via phone at (763) 412-1993.

Alexander Blake Sullivan is licensed to practice in Minnesota (license number 30850) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1922622042.

Contact Information

	Alexander Blake Sullivan, LCSW, LICSW, LIMHP
	2786 Fairview Ave N Ste 38, Roseville, MN 55113-1306
	(763) 412-1993
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Alexander Blake Sullivan
Gender	Male
Speciality	Social Worker - Clinical
Location	2786 Fairview Ave N Ste 38, Roseville, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1922622042
Provider Enumeration Date: 06/04/2020
Last Update Date: 10/23/2024

Medicare PECOS Information:

PECOS PAC ID: 8820407190
Enrollment ID: I20210518000450

Medical Identifiers

Medical identifiers for Alexander Blake Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1922622042	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	11498-C (Nevada)	Secondary
1041C0700X	Social Worker - Clinical	30850 (Minnesota)	Primary
1041C0700X	Social Worker - Clinical	SW16639 (Florida)	Secondary
1041C0700X	Social Worker - Clinical	13344228-3501 (Utah)	Secondary
1041C0700X	Social Worker - Clinical	3594 (Nebraska)	Secondary
1041C0700X	Social Worker - Clinical	CSW.09929192 (Colorado)	Secondary
1041C0700X	Social Worker - Clinical	LW61539336 (Washington)	Secondary
1041C0700X	Social Worker - Clinical	21854 (Arizona)	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Alexander Blake Sullivan allows following entities to bill medicare on his behalf.

Entity Name	Quality Bhs Florida Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1689297541 PECOS PAC ID: 4082030721 Enrollment ID: O20200812002561

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Alexander Blake Sullivan is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Alexander Blake Sullivan, LCSW, LICSW, LIMHP 4905 31st Ave S, Minneapolis, MN 55417-1403 Ph: (352) 551-4375	Alexander Blake Sullivan, LCSW, LICSW, LIMHP 2786 Fairview Ave N Ste 38, Roseville, MN 55113-1306 Ph: (763) 412-1993

Reviews and Comments

Social Worker in Roseville, MN

Samuel Johnson, Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 2680 Snelling Ave N Ste 200, Roseville, MN 55113 Phone: 651-364-9381
Andrea Mccormick, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2277 Highway 36 W Ste 310, Roseville, MN 55113 Phone: 651-252-7755 Fax: 612-331-3520
Lisa M Borneman, DSW, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2233 Hamline Ave N Ste 512, Roseville, MN 55113 Phone: 651-690-6721
Jean Gregg, LICSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 2233 Hamline Ave N Ste 435, Roseville, MN 55113 Phone: 651-216-1935
Errin Marie Musich, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 2277 Highway 36 W Ste 160, Roseville, MN 55113 Phone: 763-575-8086
Cimena Gordon, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2277 Highway 36 W, Suite 310, Roseville, MN 55113 Phone: 651-224-2172
Samantha Oren, LGSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2700 Snelling Ave N Ste 400, Roseville, MN 55113 Phone: 763-210-4698

Alexander Blake Sullivan, LCSW, LICSW, LIMHP - Medicare Clinical Social Worker in Roseville, MN