Active NPI
Mary O'Leary, PHD
- Psychologist
- Bainbridge Island, WA
National Provider Identifier
1629136676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY60025556
- Practice address
- 998 Vineyard LN Unit J301
Bainbridge Island, WA 98110-3802 - Phone
- (206) 777-5726
- NPI assigned
- Dec 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | PY60025556 | WA | Primary |
Addresses
Primary practice location
998 Vineyard LN Unit J301
Bainbridge Island, WA 98110-3802
Mailing address
PO Box 10249
Bainbridge Island, WA 98110-0249
Phone (206) 777-5726
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | www.maryolearyphd.com | Direct | |
| Other URL | www.maryolearyphd.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2023 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625184000000",
"number": "1629136676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10249",
"city": "BAINBRIDGE ISLAND",
"state": "WA",
"postal_code": "981100249",
"telephone_number": "206-777-5726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "998 VINEYARD LN UNIT J301",
"city": "BAINBRIDGE ISLAND",
"state": "WA",
"postal_code": "981103802",
"telephone_number": "206-777-5726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'LEARY",
"first_name": "MARY",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2021-07-02",
"certification_date": "2021-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "PY60025556",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "www.maryolearyphd.com",
"affiliation": "N",
"endpointDescription": "website",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "direct",
"address_1": "998 Vineyard Ln Unit J301",
"city": "Bainbridge Island",
"state": "WA",
"country_code": "US",
"postal_code": "981103802",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "www.maryolearyphd.com",
"affiliation": "N",
"address_1": "998 Vineyard Ln Unit J301",
"city": "Bainbridge Island",
"state": "WA",
"country_code": "US",
"postal_code": "981103802",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bainbridge Island, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.