Active NPI
Mary Diane Sichi, PSYD
- Counseling Psychologist
- Corvallis, OR
National Provider Identifier
1104298579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 2787
- Practice address
- 408 SW Monroe Ave Ste M210D
Corvallis, OR 97333-7228 - Phone
- (541) 833-7894
- Fax
- (855) 461-3350
- NPI assigned
- Oct 26, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 2787 | OR | Primary |
Addresses
Primary practice location
408 SW Monroe Ave Ste M210D
Corvallis, OR 97333-7228
Mailing address
408 SW Monroe Ave Ste M210D
Corvallis, OR 97333-7228
Phone (541) 833-7894
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2022 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781740800000",
"number": "1104298579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "408 SW MONROE AVE STE M210D",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973337228",
"telephone_number": "541-833-7894",
"fax_number": "855-461-3350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "408 SW MONROE AVE STE M210D",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973337228",
"telephone_number": "541-833-7894",
"fax_number": "855-461-3350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SICHI",
"first_name": "MARY",
"middle_name": "DIANE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-26",
"last_updated": "2026-06-18",
"certification_date": "2026-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "OR",
"license": "2787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.