Kelly Marie Sullivan, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3498 Issued in NC

Practice address

1121 W Chapel Hill St Ste 100
Durham, NC 27701-3080

Phone

(919) 385-0733

NPI assigned

Jan 24, 2007

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

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Duke Health Integrated Practice, Inc.

  • General Practice Physician
  • Durham, NC
  • NPI 1205553369
  Medicare reassignment NPD
• Duke University Health System, Inc.

  • Certified Registered Nurse Anesthetist
  • Durham, NC
  • NPI 1558392977
  Medicare reassignment NPD
• Center for Child and Family Health

  • Professional Counselor
  • Durham, NC
  • NPI 1982747747
  NPD (past) Authorized official
• Duke University Health System, Inc.

  • Family Medicine Physician
  • Durham, NC
  • NPI 1336448810
  NPD
• Duke University Health System, Inc.

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Durham, NC
  • NPI 1427187525
  NPD

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1639224025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 W CHAPEL HILL ST STE 100",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277013080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 W CHAPEL HILL ST STE 100",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277013080",
            "telephone_number": "919-385-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "3498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Danielle Sullivan, DNP, FNP-BC
• Jennifer Anne Sullivan, MS, CGC
• John Stevens Sullivan II, LMFTA
• Keith Sullivan, M.D.
• Kelly Sullivan
• Marianne Koehler Sullivan, OTR/L
• Marija Sullivan, MD
• Mark Sullivan, MSW
• Sarah Sullivan, CPNP-AC
• Lewis Erik Philip Sulman, MD, PHD

• Psychologist in Durham, NC
• Providers in Durham, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.