Active NPI
Mary Jane Mulvey Gandour, MD
- Psychologist
- Lafayette, IN
National Provider Identifier
1336117498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 20040331A
- Practice address
- 2020 Union St
Suite 101
Lafayette, IN 47904-2694 - Phone
- (765) 449-8286
- Fax
- (765) 449-0445
- NPI assigned
- Mar 14, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 20040331A | IN | Primary |
Addresses
Primary practice location
2020 Union St
Suite 101
Lafayette, IN 47904-2694
Mailing address
PO Box 4699
Lafayette, IN 47903-4699
Phone (765) 449-8286
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20040331A | IN | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Unity Healthcare LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Lafayette Vein and Vascular
- Vascular Surgery Physician
- Lafayette, IN
- NPI 1427759182
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1336117498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4699",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479034699",
"telephone_number": "765-449-8286",
"fax_number": "765-449-0445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 UNION ST",
"address_2": "SUITE 101",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479042694",
"telephone_number": "765-449-8286",
"fax_number": "765-449-0445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANDOUR",
"first_name": "MARY JANE",
"middle_name": "MULVEY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-14",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IN",
"license": "20040331A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.