Kelly Sullivan

Primary specialty

Social WorkerTaxonomy code 104100000X

License

44SC06457800 Issued in NJ

Practice address

24 Lees Ave
Collingswood, NJ 08108-2070

Phone

(856) 240-0868

NPI assigned

Jul 19, 2021

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

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.

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.

• Mind Body Soul Wellness Center LLC

  • Professional Counselor
  • Collingswood, NJ
  • NPI 1487152542
  NPD (past)

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1962075069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 LEES AVE",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081082070",
            "telephone_number": "856-240-0868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 LEES AVE",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081082070",
            "telephone_number": "856-240-0868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SC06457800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Stancill, LMT
• Sabrina Beth Starts
• Phillip Steinhauer
• Alison Stewart, MA CCC-SLP
• Jessica Straight
• Sunrise Psychological Services LLC
• Helen Sykes, M.ED, BCBA
• The Care Springs LLC
• The Village - South Jersey Breastfeeding & Wellness
• The Well Chiropractic

• Social Worker in Collingswood, NJ
• Providers in Collingswood, NJ by specialty
• Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; 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.