Individual provider Active NPI

Mary Sullivan, MFT

  • Marriage & Family Therapist
  • Fort Collins, CO
National Provider Identifier
1720410475
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT.0001310 Issued in CO
Practice address
4333 Corbett Dr # 1196
Fort Collins, CO 80525-6111
Phone
(970) 310-3406
NPI assigned
Aug 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT-351 HI
Marriage & Family Therapist 106H00000X MFT.0001310 CO Primary

Addresses

Primary practice location

4333 Corbett Dr # 1196
Fort Collins, CO 80525-6111

Mailing address

4333 Corbett Dr # 1196
Fort Collins, CO 80525-6111
Phone (970) 310-3406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20240715001240 CO Practitioner - Marriage and Family Therapist 3173068145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

439 Stoney Brook Rd
Fort Collins, CO 80525-8705
Phone (970) 541-9534

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT-351HIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Finding Peace in Empowerment, LLC Marriage & Family Therapist CurrentSince May 28, 2024 Accepting new patients
Oasis for Change, LLC Marriage & Family Therapist CurrentSince May 28, 2024 Accepting new patients

Locations

4333 Corbett Dr
Fort Collins, CO 80525
Phone (205) 213-2571

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1375660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1720410475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4333 CORBETT DR # 1196",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805256111",
            "telephone_number": "970-310-3406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4333 CORBETT DR # 1196",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805256111",
            "telephone_number": "970-310-3406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MARY",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-05",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "HI",
            "license": "LMFT-351",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CO",
            "license": "MFT.0001310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.