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KELSEY SULLIVAN CCC-SLP
NPI 1346506789
Speech-Language Pathologist in Glen Carbon, IL

Active since April 10, 2012Accepts Medicare Assignment
200 S STATION RD, GLEN CARBON, IL 62034(618) 288-5014 Get Directions Write a Review

NPPES record last updated: May 2, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 2, 2022, Nov 13, 2016 (2 updates tracked since 2016).

About Kelsey Sullivan Ccc-slp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELSEY SULLIVAN CCC-SLP (NPI 1346506789) is an individual speech-language pathologist provider in Glen Carbon, Illinois, licensed in Illinois (146011094) and active in the NPI registry since April 2012. She is a graduate of Other (2011).

NPPES Registry Identity

NPI1346506789
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameKELSEY SULLIVANCredential: CCC-SLP
Location Address200 S STATION RDGlen Carbon, IL 62034-2777
Mailing Address209 W Division StMaryville, IL 62062-6831 · (618) 719-1582
Phone(618) 288-5014
Sole ProprietorYes
Medical School CMSOtherGraduated 2011
Enumeration DateApril 10, 2012
Last NPPES UpdateMay 2, 20222 updates tracked since enumeration
NPPES CertifiedMay 2, 2022
✔ NPI 1346506789 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License✔ Licensed in IL · 146011094
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
200 S STATION RD, Glen Carbon, IL 62034
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Other Names 1

Former Name (1)Kelsey Hubert

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelsey Sullivan Ccc-slp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8224415336
PECOS Enrollment IDI20220511000983

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelsey Sullivan's NPI number?

The NPI number for Kelsey Sullivan is 1346506789. It was assigned to this individual provider in the NPPES registry on April 10, 2012. The provider is also known as Kelsey Hubert.

Where is Kelsey Sullivan located?

Kelsey Sullivan practices at 200 S Station Rd, Glen Carbon, IL 62034. The listed phone number is (618) 288-5014.

What is Kelsey Sullivan's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Kelsey Sullivan enrolled in Medicare?

Yes. Kelsey Sullivan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kelsey Sullivan was last updated on May 2, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.