Kelly Sullivan

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP-7193 Issued in OH

Practice address

14105 Snow Rd
Brookpark, OH 44142-2557

Phone

(216) 676-4334

NPI assigned

Oct 29, 2014

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

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1568867877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34918 CAMBRIDGE DR",
            "city": "NORTH RIDGEVILLE",
            "state": "OH",
            "postal_code": "440393981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14105 SNOW RD",
            "city": "BROOKPARK",
            "state": "OH",
            "postal_code": "441422557",
            "telephone_number": "216-676-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-29",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP-7193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katharine Stegman
• Brooke Stephens
• Taijha Stewart, RBT
• Stonewood Residential Inc.
• Mary E Stupczy, PT
• Janelle Sutton, QMHS
• Marisa Taylor
• Sharon Tidwell
• Emily Tilley
• Debra A. Tkac, L.P.C.C.-S

• Speech-Language Pathologist in Brookpark, OH
• Providers in Brookpark, OH by specialty
• Speech-Language Pathologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; 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.