DR. KELLY MARIE SULLIVAN PH.D.
NPI 1639224025
Psychologist in Durham, NC

Active since January 24, 2007PECOS EnrolledAccepts Medicare Assignment
1121 W CHAPEL HILL ST STE 100, DURHAM, NC 27701(919) 385-0733 Get Directions Write a Review

NPPES record last updated: July 15, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 27, 2016, May 18, 2016 (2 updates tracked since 2016).

About Dr. Kelly Marie Sullivan Ph.d. NPPES

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

DR. KELLY MARIE SULLIVAN PH.D. (NPI 1639224025) is an individual psychologist in Durham, North Carolina, licensed in North Carolina (3498) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS and is a graduate of University Of North Carolina At Chapel Hill School Of Medicine (2005).

NPPES Registry Identity

NPI1639224025
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. KELLY MARIE SULLIVANCredential: PH.D.
Location Address1121 W CHAPEL HILL ST STE 100Durham, NC 27701-3080
Mailing Address1121 W Chapel Hill St Ste 100Durham, NC 27701-3080
Sole ProprietorNo
Medical School CMSUniversity Of North Carolina At Chapel Hill School Of MedicineGraduated 2005
Enumeration DateJanuary 24, 2007
Last NPPES UpdateJuly 15, 20252 updates tracked since enumeration
NPPES CertifiedJuly 15, 2025
NPI 1639224025 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in NC · 3498
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
1121 W CHAPEL HILL ST STE 100, Durham, NC 27701

Accepted Insurance

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

Dr. Kelly Marie Sullivan Ph.d. 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 ID6901313162
PECOS Enrollment IDI20250730004416
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 8

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

Counselor (Professional)
1121 W CHAPEL HILL ST STE 100
DURHAM, NC 27701
Psychologist
1121 W CHAPEL HILL ST STE 100
DURHAM, NC 27701
Counselor (Professional)
1121 W CHAPEL HILL ST STE 100
DURHAM, NC 27701
Counselor (Professional)
1121 W CHAPEL HILL ST STE 100
DURHAM, NC 27701
Social Worker (Clinical)
1121 W CHAPEL HILL ST STE 100
DURHAM, NC 27701
Counselor (Mental Health)
1121 W CHAPEL HILL ST STE 100
DURHAM, NC 27701
Psychologist
1121 W CHAPEL HILL ST STE 100, #908
DURHAM, NC 27701
Counselor (Mental Health)
1121 W CHAPEL HILL ST STE 100
DURHAM, NC 27701

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 Kelly Sullivan's NPI number?

The NPI number for Kelly Sullivan is 1639224025. It was assigned to this individual provider in the NPPES registry on January 24, 2007.

Where is Kelly Sullivan located?

Kelly Sullivan practices at 1121 W Chapel Hill St Ste 100, Durham, NC 27701. The listed phone number is (919) 385-0733.

What is Kelly Sullivan's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Kelly Sullivan enrolled in Medicare?

Yes. Kelly 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.

What insurance does Kelly Sullivan accept?

Health plans from Blue Cross and Blue Shield of NC list Kelly Sullivan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelly Sullivan was last updated on July 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.