Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Kelli Lynn Sullivan, PHD

Individual provider Clinical Neuropsychologist · NPI 1659060333

Dr. Kelli Lynn Sullivan, PHD is a Clinical Psychologist in Providence, Rhode Island. Qualified in 2021, 5 years ago. Practices with Lifespan Physician Group Inc, a 1,125-clinician group and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
5
Licensed in
RI
In the registry since
2023
Specialties on file
2
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

146 W River St Ste 11A
Providence, RI 02904
Phone: (401) 793-4006
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PS02160 (RI)
Clinical Neuropsychologist Taxonomy 103G00000X

Record details

NPI number1659060333
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorNo
NPI enumeratedMay 8, 2023
Last updated in NPPESSeptember 11, 2023
Certification dateSeptember 11, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Lifespan Physician Group Inc — 1125 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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