MARY JOHN MARY SULLIVAN (LMFT) – Marriage & Family Therapist, NPI 1104164763

MARY JOHN MARY SULLIVAN (LMFT) is a healthcare provider. based in Meriden, Connecticut. specializing in MARRIAGE AND FAMILY THERAPIST. They hold the professional credentials LMFT. They hold a License No. 001568 (CT). The NPI Number for MARY JOHN MARY SULLIVAN (LMFT) is 1104164763

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
MARY JOHN MARY SULLIVAN (LMFT)
NPI
1104164763
Phone
(203) 237-8084
Address
271 FINCH AVE
Enumeration Date
16 January 2013
Last Update Date
16 January 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2032378084
Graduation Year
2010 (16 years ago)
PAC ID
8224541487
Group Practice PAC ID
1456307792
Professional Enrollment ID
I20250701000877
Address ID
CT064512715ME271XXAVEX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:13State licenses:1Digital endpointsOther names

278 MARRIAGE AND FAMILY THERAPIST in CT

Provider Addresses for MARY JOHN MARY SULLIVAN (LMFT)

  • 271 FINCH AVE

    MERIDEN, CT 064512715

    Phone: (203) 237-8084

    Fax: (203) 639-1333

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-07-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250701000877IMarriage And Family TherapistCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06451)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1456307792View full group profile
NameSpecialtyState
Mental Health CounselorCT
Clinical PsychologistCT
Marriage And Family TherapistCT
Marriage And Family TherapistCT
P S Y C H I A T R YCT
Marriage And Family TherapistCT
Marriage And Family TherapistCT
Marriage And Family TherapistCT
Marriage And Family TherapistCT
P S Y C H I A T R YCT

Reviews

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Frequently asked questions

How do I look up MARY JOHN MARY SULLIVAN (LMFT) by NPI?
Use NPI 1104164763 when you need to reference MARY JOHN MARY SULLIVAN (LMFT) in forms, claims, or directories.
Does this profile mean MARY JOHN MARY SULLIVAN (LMFT) is currently active?
Yes — MARY JOHN MARY SULLIVAN (LMFT) appears active in the national provider directory.
What field does MARY JOHN MARY SULLIVAN (LMFT) work in?
You can think of MARY JOHN MARY SULLIVAN (LMFT) as practicing within Marriage & Family Therapist. Clinical services aligned with this taxonomy classification.
Does MARY JOHN MARY SULLIVAN (LMFT) practice in Connecticut?
You will see Meriden, Connecticut on file for MARY JOHN MARY SULLIVAN (LMFT) alongside any extra practice locations.
Is MARY JOHN MARY SULLIVAN (LMFT) a real provider?
This page reflects official NPPES data for NPI 1104164763. Always confirm identity and privileges with the practice and licensing boards.

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