MS. KENNA M. SULLIVAN (LICSW) – Clinical Social Worker, NPI 1942410402

MS. KENNA M. SULLIVAN (LICSW) is a healthcare provider. based in Boston, Massachusetts. specializing in Clinical Social Worker. They hold the professional credentials LICSW. They hold a License No. 107098 (MA). The NPI Number for MS. KENNA M. SULLIVAN (LICSW) is 1942410402

Main info

Female
Sole Proprietor
44 Years Of Experience
Accepts Medicare Assignment
Name
MS. KENNA M. SULLIVAN (LICSW)
NPI
1942410402
Phone
Not provided
Address
960 MASSACHUSETTS AVE STE 2
Enumeration Date
23 May 2007
Last Update Date
8 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7817299000
Graduation Year
1982 (44 years ago)
PAC ID
7618922543
Group Practice PAC ID
9638195605
Professional Enrollment ID
I20050314000908
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for MS. KENNA M. SULLIVAN (LICSW)

  • 960 MASSACHUSETTS AVE STE 2

    BOSTON, MA 021182690

    Phone:

    Type: Mailing

  • 692, Washington Street, Oak Square, Brighton, Boston, Suffolk County, Massachusetts, 02472, United States

    BRIGHTON, MA 021351537

    Phone: (617) 312-8067

    Fax: (617) 254-9479

    Type: Location

  • 1 Boston Medical Ctr Pl

    Boston, MA 021182908

    Phone: (617) 414-5245

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02118)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9638195605View full group profile
NameSpecialtyState
GAIL FORTHOFFER (N.P.)
-MA
MS. GABRIELA BOHRER CARVALHO
-MA
KIMBERLY A. CRANE (LICSW)
-MA

Reviews

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Frequently asked questions

What is the registry number for MS. KENNA M. SULLIVAN (LICSW)?
The registry entry for MS. KENNA M. SULLIVAN (LICSW) shows NPI 1942410402.
Quick check: is MS. KENNA M. SULLIVAN (LICSW) active?
Public NPPES data shows MS. KENNA M. SULLIVAN (LICSW) with an active NPI status right now.
What type of care does MS. KENNA M. SULLIVAN (LICSW) provide?
MS. KENNA M. SULLIVAN (LICSW)'s profile centers on Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Which community is linked to MS. KENNA M. SULLIVAN (LICSW)?
MS. KENNA M. SULLIVAN (LICSW) shows a connection to Boston, Massachusetts in registry-derived data.
Can I export MS. KENNA M. SULLIVAN (LICSW)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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