Shannon O'Sullivan, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC008395 Issued in PA

Practice address

4200 School LN
Drexel Hill, PA 19026-5244

Phone

(484) 919-2632

NPI assigned

Oct 29, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Marvin Behavioral Health Ma PC

  • Psychologist
  • Boston, MA
  • NPI 1740860428
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1053783035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 SCHOOL LN",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190265244",
            "telephone_number": "484-919-2632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 SCHOOL LN",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190265244",
            "telephone_number": "484-919-2632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 Reservoir Ave Ste 203",
            "address_purpose": "LOCATION",
            "city": "Cranston",
            "state": "RI",
            "postal_code": "029206032",
            "country_code": "US",
            "telephone_number": "401-259-0340",
            "fax_number": "401-213-8538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'SULLIVAN",
        "first_name": "SHANNON",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-29",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC008395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Novacare Outpatient Rehabilitation East, Inc.
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• Charles O'Donnell Jr., MSN, CRNP, PMHNP-BC
• Megan Smith O'Sullivan, MS, OTR/L
• Temitope Ogungbemi, LBS
• Bennett Okyere
• Oline Tree Medical Practice
• Omo Passionate Home Healthcare, LLC
• Oriental Acu Herb LLC

• Professional Counselor in Drexel Hill, PA
• Providers in Drexel Hill, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.