Kelly Sullivan

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37AC00800800 Issued in NJ

Practice address

63 W Main St
Freehold, NJ 07728-2140

Phone

(347) 948-6402

NPI assigned

Jul 4, 2024

Sex

Female

Sole proprietor

No

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.

• Peace of Mind Counseling & Consulting

  • Professional Counselor
  • Freehold, NJ
  • NPI 1285412296
  NPD (past)

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

{
    "created_epoch": "1720051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720051200000",
    "number": "1144066580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 BARTON AVE",
            "city": "POINT PLEASANT BORO",
            "state": "NJ",
            "postal_code": "087424272",
            "telephone_number": "732-456-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 W MAIN ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282140",
            "telephone_number": "347-948-6402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-04",
        "last_updated": "2024-07-04",
        "certification_date": "2024-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37AC00800800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myiah Sturdivant, OTD, OTR/L
• Melanie Sudia, LCSW
• Jorge Sirot Suening, MD
• Troy Sukkarieh, MD
• Suzette J Sularski, PSY.D.
• Brian Sultana, PHARM D
• Sumaiya Inc
• Summit Medical Group PA
• Sunrise Home Services LLC
• Jayna Suoninen

• Mental Health Counselor in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2024; 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.