Lauren Sullivan, LPC, MED, MS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC016591 Issued in PA

Practice address

424 Boxwood Rd
Bryn Mawr, PA 19010-1222

Phone

(610) 955-7892

NPI assigned

Jan 19, 2021

Last updated

Dec 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 17, 2024 through Dec 17, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education, Master of Science

State licenses

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1235729716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 BOXWOOD RD",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190101222",
            "telephone_number": "610-955-7892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 BOXWOOD RD",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190101222",
            "telephone_number": "610-955-7892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LAUREN",
        "credential": "LPC, MED, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-19",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC016591",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC016591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL COUNSELOR",
            "identifier": "PC016591",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alena Subacus
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• Stephanie Sudjian
• Sherry M Sukol, PHD
• Anna F Sullivan, MS
• Nancy Sullivan, NBC-HWC
• Sean Sullivan
• Richard Fredric Summers, MD
• Summit Grove Counseling, LLC
• Summit Grove Therapy

• Professional Counselor in Bryn Mawr, PA
• Providers in Bryn Mawr, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.