Active NPI
Susan Tully-Young, RNC
- Child & Adolescent Psychiatric/Mental Health Registered Nurse
- Westbrook, ME
National Provider Identifier
1487827309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatric/Mental Health Registered Nurse
- License
- RO34651
- Practice address
- 16 Saunders Way
Westbrook, ME 04092-4833 - Phone
- (207) 878-9663
- Fax
- (207) 797-6137
- NPI assigned
- Apr 11, 2008
- 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 |
|---|---|---|---|---|
| Child & Adolescent Psychiatric/Mental Health Registered Nurse | 163WP0807X | RO34651 | ME | Primary |
Addresses
Primary practice location
16 Saunders Way
Westbrook, ME 04092-4833
Mailing address
PO Box 1768
Portland, ME 04104-1768
Phone (207) 878-9663
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RO34651 | ME | MD | Child & Adolescent Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377043200000",
"number": "1487827309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1768",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041041768",
"telephone_number": "207-878-9663",
"fax_number": "207-797-6137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 SAUNDERS WAY",
"city": "WESTBROOK",
"state": "ME",
"postal_code": "040924833",
"telephone_number": "207-878-9663",
"fax_number": "207-797-6137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TULLY-YOUNG",
"first_name": "SUSAN",
"credential": "RNC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-11",
"last_updated": "2013-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0807X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
"state": "ME",
"license": "RO34651",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westbrook, ME
- Tranquility Counseling Services, LLC
- Sara B. Tremblay, LMSW-CC
- Triple Trend Global LLC (Personal Care Agency)
- Timothy G True, LCSW
- Sara Jacobson Tsaitsios, PMHNP
- Gillian Elizabeth Turco, COTA
- Isabella Turner, OT
- Sarah Elizabeth Underwood, LMSW-CC
- Priscilla Urban, LMT, CDT
- Catherine Lynn Vajda, MA CCC/SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.