DR. MAURA D. SULLIVAN (NPI# 1639110273) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639110273 |
| Entity Type | Individual |
| Full Name | DR. MAURA D. SULLIVAN |
| Credential | PSY.D. |
| Practice Address |
25 Ne 47th Ave Ste 4 Portland OR 97213-2316 |
| Practice Telephone | 6036168488 |
| Mailing Telephone | 5034328470 |
| Mailing Fax Number | 5039127018 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2020-06-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
1012 | NH | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NH | 30425095 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598230765 | Maura Sullivan | Pharmacist | 2404 S Perryville Rd, Rockford, IL 61108-8231 | 2018-10-03 |
| 1255526810 | Maura K Sullivan | Physician Assistant | 1535 Gull Road, Suite 105, Kalamazoo, MI 49048-1630 | 2007-09-07 |
| 1427175249 | Maura Corcoran Sullivan | Psychologist | 178 Middle St, Suite 300, Portland, ME 04101-4075 | 2007-03-25 |
| 1902838071 | Maura Sullivan | Family Medicine | 2400 Us Route 9, Hudson, NY 12534-4725 | 2006-07-07 |
| 1215909528 | Maura Ellen Sullivan | Pediatrics | 15 Parkman St, Pediatric Medicine Wac 715, Boston, MA 02114-3117 | 2006-02-02 |
| Street Address |
25 NE 47TH AVE STE 4 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97213-2316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588021331 | Megan Quigley | Social Worker | 25 Ne 47th Ave, Portland, OR 97213-2316 | 2016-01-25 |
| 1356734313 | Carie Arps | Counselor | 25 Ne 47th Ave, Portland, OR 97213-2316 | 2015-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831715176 | Darnell Jackie Strong | Social Worker | 435 Ne 78th Ave 'strong Counseling Services', Portland, OR 97213 | 2020-06-23 |
| 1336775907 | Redpoint Physical Therapy and Performance LLC | Physical Therapist | 4200 Ne Flanders St Unit B, Portland, OR 97213 | 2020-03-16 |
| 1801431218 | Denise Dorgan-miller | Occupational Therapy Assistant | Providence Elder Place, 4400 Ne Halsey Suite 200, Portland, OR 97213 | 2019-11-08 |
| 1619435617 | Aspiration of Character Counseling Services, LLC | Counselor | 4424 Ne Glisan St, The Li Wellness Building, Second Floor, Portland, OR 97213 | 2019-03-08 |
| 1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
| 1023507795 | Karissa Lynn Schwartz | Speech-Language Pathologist | Providence Portland Medical Center, 4805 Ne Glisan St, Portland, OR 97213 | 2018-05-08 |
| 1861944506 | James Livingston Taylor | Chiropractor | 5212 Ne Sacremento St., Portland, OR 97213 | 2016-10-28 |
| 1962958520 | Caitlin Turner | Massage Therapist | 4317 Ne Tillamook St., Portland, OR 97213 | 2016-09-01 |
| 1326407008 | Julianna Vermeys | Counselor | 4605 Ne Fremont St., 209a, Portland, OR 97213 | 2016-02-23 |
| 1881059822 | Thomas Michael Barrett | Counselor | 5228 Ne Hoyt St. Bldg. B, Portland, OR 97213 | 2015-12-17 |
| Find all providers in zip 97213 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861007387 | Lyle Vintinner | Psychologist | 53 Baxter Blvd Ste 3, Portland, ME 04101-1827 | 2020-09-11 |
| 1194341297 | Natalie Dawn Mitchell | Psychologist | 3762 Sw Council Crest Dr, Portland, OR 97239-1595 | 2020-06-24 |
| 1992331607 | Erin A. Mueller | Psychologist | 718 Sw Alder St Ste 200, Portland, OR 97205-3423 | 2020-03-14 |
| 1952940520 | Timothy Allen Cooper | Psychologist | 3331 Sw Hamilton Ct, Portland, OR 97239-1256 | 2019-12-31 |
| 1215574058 | Northwest Dbt LLC | Psychologist | 2230 Nw Pettygrove St., Suite 130, Portland, OR 97210 | 2019-11-27 |
| 1093373631 | Emily Catherine Stasko | Psychologist | 1950 Nw Raleigh St Apt 201, Portland, OR 97209-1775 | 2019-05-29 |
| 1174094544 | Juniper Psychological Services | Psychologist | 2827 Ne Alberta St, Portland, OR 97211-6350 | 2018-12-11 |
| 1528539335 | Mark G Kiefner Phd LLC | Psychologist | 225 Commercial St Ste 403, Portland, ME 04101-6603 | 2018-12-06 |
| 1467941831 | Shannon Madore | Psychologist | 3710 Sw Us Veterans Hospital Rd # R&d66, Portland, OR 97239-2964 | 2018-05-01 |
| 1033637202 | Kaylin Jones | Psychologist | 1235 Se Division Street, Suite 115, Portland, OR 97202-9720 | 2017-09-07 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.