Individual provider Active NPI

Mary John Mary Sullivan, LMFT

  • Marriage & Family Therapist
  • Meriden, CT
National Provider Identifier
1104164763
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
001568 Issued in CT
Practice address
271 Finch Ave
Meriden, CT 06451-2715
Phone
(203) 237-8084
Fax
(203) 639-1333
NPI assigned
Jan 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 001568 CT Primary

Addresses

Primary practice location

271 Finch Ave
Meriden, CT 06451-2715

Mailing address

271 Finch Ave
Meriden, CT 06451-2715
Phone (203) 237-8084

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250701000877 CT Practitioner - Marriage and Family Therapist 8224541487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Life Center Network, IncorporatedGroup PAC ID 1456307792, 12 clinicians

Practice addresses (Care Compare)

271 Finch Ave
Meriden, CT 06451-2715
Phone (203) 237-8084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001568CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Life Center Network, Incorporated CurrentSince Mar 21, 2025 Accepting new patients
Franciscan Life Center Network, Incorporated PastSince Mar 21, 2025 Accepting new patients

Locations

271 Finch Ave
Meriden, CT 06451
Phone (203) 237-8084

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1358294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1104164763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 FINCH AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512715",
            "telephone_number": "203-237-8084",
            "fax_number": "203-639-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 FINCH AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512715",
            "telephone_number": "203-237-8084",
            "fax_number": "203-639-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MARY JOHN",
        "middle_name": "MARY",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-16",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

Verify at the official NPI Registry.