Maura Corcoran Sullivan, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS837 Issued in ME

Practice address

178 Middle St
Suite 300
Portland, ME 04101-4075

Phone

(207) 871-0447

Fax

(207) 772-2670

NPI assigned

Mar 25, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

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

Specialty

Clinical Psychologist

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• E. Merle Bragdon, PHD, PA

  • Clinical Psychologist
  • Portland, ME
  • NPI 1598069312
  NPD (past)
• Tom Negron, PH.D, PA

  dba tom negron, ph.d.

  • Clinical Psychologist
  • Gorham, ME
  • NPI 1194973131
  NPD (past)

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427175249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 MIDDLE ST",
            "address_2": "SUITE 300",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041014075",
            "telephone_number": "207-871-0447",
            "fax_number": "207-772-2670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 MIDDLE ST",
            "address_2": "SUITE 300",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041014075",
            "telephone_number": "207-871-0447",
            "fax_number": "207-772-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MAURA",
        "middle_name": "CORCORAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "PS837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Sullivan
• Karli Sullivan, PA
• Kathleen K Sullivan, LMFT
• Kevin George Sullivan, M.D.
• Lorraine Louise Sullivan, PNP
• Michael P Sullivan, MD
• William M Sullivan, M.D.
• Jennie S Summers-Shea, LCPC
• Sun Valley Plus LLC
• Ningyuan Sun

• Clinical Psychologist in Portland, ME
• Providers in Portland, ME by specialty
• Clinical Psychologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.