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KENISHA SULLIVAN LPC
NPI 1437831328
Counselor - Professional in Havertown, PA

Active since August 01, 2023PECOS Enrolled
1120 W TOWNSHIP LINE RD STE 200, HAVERTOWN, PA 19083(484) 451-8313 Get Directions Write a Review

NPPES record last updated: October 16, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kenisha Sullivan Lpc NPPES

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

KENISHA SULLIVAN LPC (NPI 1437831328) is an individual professional provider in Havertown, Pennsylvania, licensed in Pennsylvania (PC019492) and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1437831328
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameKENISHA SULLIVANCredential: LPC
Location Address1120 W TOWNSHIP LINE RD STE 200Havertown, PA 19083-4930
Mailing Address3111 W Allegheny Ave Apt 327Philadelphia, PA 19132-1134 · (267) 648-1977
Phone(484) 451-8313
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateAugust 1, 2023
Last NPPES UpdateOctober 16, 2025
NPPES CertifiedOctober 16, 2025
✔ NPI 1437831328 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in PA · PC019492
1120 W TOWNSHIP LINE RD STE 200, Havertown, PA 19083
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenisha Sullivan Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7517440480
PECOS Enrollment IDI20260310002812
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHARNA STANSBURY LPN
Licensed Practical Nurse
1120 W TOWNSHIP LINE RD STE 200
HAVERTOWN, PA 19083
Delaware County (877) 286-5115

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 Kenisha Sullivan's NPI number?

The NPI number for Kenisha Sullivan is 1437831328. It was assigned to this individual provider in the NPPES registry on August 1, 2023.

Where is Kenisha Sullivan located?

Kenisha Sullivan practices at 1120 W Township Line Rd Ste 200, Havertown, PA 19083. The listed phone number is (484) 451-8313.

What is Kenisha Sullivan's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Kenisha Sullivan enrolled in Medicare?

Yes. Kenisha Sullivan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kenisha Sullivan was last updated on October 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.