Active NPI
Lori Michelle Tirado, LP
- Clinical Psychologist
- Portland, ME
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS2757
- Practice address
- 53 Baxter Blvd Ste 3
Portland, ME 04101-1827 - Phone
- (603) 883-0005
- NPI assigned
- Jun 19, 2014
- Last updated
- Jul 31, 2026
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 24105 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carenet Inc | Current | Accepting new patients | |
| Lifesource of North Carolina | Clinical | Current | Accepting new patients |
| Lifesource of North Carolina | Psychologist | Current | Accepting new patients |
| Carenet, Inc. | Current | Accepting new patients | |
| Carenet, Inc | Past | 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.
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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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.