Individual provider Active NPI

Lori Michelle Tirado, LP

  • Clinical Psychologist
  • Portland, ME
National Provider Identifier
1396159117
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS2757 Issued in ME
Practice address
53 Baxter Blvd Ste 3
Portland, ME 04101-1827
Phone
(603) 883-0005
NPI assigned
Jun 19, 2014
Last updated
Jul 31, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 24105 CA
Clinical Psychologist 103TC0700X PS2757 ME Primary

Addresses

Primary practice location

53 Baxter Blvd Ste 3
Portland, ME 04101-1827

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 716-9034

Other practice location 1

3205 Randall Pkwy Ste 105
Wilmington, NC 28403-2565
Phone (910) 742-9243

Other practice location 2

403 S Hawthorne Rd
Winston Salem, NC 27103-3784
Phone (336) 716-0855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20141023002695 NC Practitioner - Clinical Psychologist 2365663960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carenet IncGroup PAC ID 6406845262, 40 clinicians

Practice addresses (Care Compare)

403 S Hawthorne Rd
Winston Salem, NC 27103-3784
Phone (336) 716-0855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
24105CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Carenet Inc CurrentSince Jun 19, 2024 Accepting new patients
Lifesource of North Carolina Clinical CurrentSince Sep 1, 2014 Accepting new patients
Lifesource of North Carolina Psychologist CurrentSince Sep 1, 2014 Accepting new patients
Carenet, Inc. CurrentSince Jun 19, 2024 Accepting new patients
Carenet, Inc PastSince May 25, 2021 Accepting new patients

Locations

114 Highland Ave
Fayetteville, NC 28305
Phone (910) 484-0176

3219 Landmark St
Ste 9
Greenville, NC 27834

3205 Randall Pkwy
Ste 105
Wilmington, NC 28403
Phone (910) 338-2880

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

403 S Hawthorne Rd
Winston Salem, NC 27103
Phone (336) 716-0800

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1396159117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-716-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 BAXTER BLVD STE 3",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041011827",
            "telephone_number": "603-883-0005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3205 Randall Pkwy Ste 105",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284032565",
            "country_code": "US",
            "telephone_number": "910-742-9243",
            "fax_number": "888-746-1787",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "403 S Hawthorne Rd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271033784",
            "country_code": "US",
            "telephone_number": "336-716-0855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIRADO",
        "first_name": "LORI",
        "middle_name": "MICHELLE",
        "credential": "LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-19",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "24105",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "PS2757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.