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NPI Code Detail

MEDICARE: KENDALL CAITLIN SULLIVAN LPC

MEDICARE: KENDALL CAITLIN SULLIVAN LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor0701015671VA

General Provider Information

NPI Number : 1154288215
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENDALL CAITLIN SULLIVAN LPC
Provider Business Mailing Address
First Line : 161 SWAN FIELD AVE
Second Line :
City : RANSON
State : WV
Zip : 25438-4611
Country : US
Telephone Number : 804-721-7617
Fax Number :
Provider Business Practice Location Address
First Line : 199 LIBERTY ST SW
Second Line :
City : LEESBURG
State : VA
Zip : 20175-2715
Country : US
Telephone Number : 703-621-7121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2026
Last Update Date : 01/08/2026

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Directions to “ KENDALL CAITLIN SULLIVAN LPC” Practice Location

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