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

Kelsey Sullivan, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1346506789

Kelsey Sullivan, CCC-SLP is a Qualified Speech Language Pathologist in Glen Carbon, Illinois. Qualified in 2011, 15 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
15
Licensed in
IL
In the registry since
2012
What do these letters mean?
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

See every abbreviation used in this directory →

Practice location Address checks out

200 S Station Rd
Glen Carbon, IL 62034-2777
Phone: (618) 288-5014
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 146011094 (IL)

Record details

NPI number1346506789
Entity typeIndividual (Type 1)
GenderFemale
Credentials CCC-SLP
Sole proprietorYes
NPI enumeratedApril 10, 2012
Last updated in NPPESMay 2, 2022
Certification dateMay 2, 2022
Mailing address209 W Division St, Maryville, IL 62062-6831

Medicare enrollment

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

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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