DR. MARK SULLIVAN HANSON (PHD) – Clinical Psychologist, NPI 1003984386

DR. MARK SULLIVAN HANSON (PHD) is a healthcare provider. based in Danvers, Massachusetts. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 6390 (MA). The NPI Number for DR. MARK SULLIVAN HANSON (PHD) is 1003984386

Main info

Male
Sole Proprietor
34 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARK SULLIVAN HANSON (PHD)
NPI
1003984386
Phone
(978) 777-1088
Address
130 CENTRE ST
Enumeration Date
2 December 2006
Last Update Date
24 May 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9787770810
Graduation Year
1992 (34 years ago)
PAC ID
3971510934
Group Practice PAC ID
7719281492
Professional Enrollment ID
I20060315000711
Address ID
MA019231400DA130XXSTXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,694 CLINICAL PSYCHOLOGIST in MA

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Provider Addresses for DR. MARK SULLIVAN HANSON (PHD)

  • Wadsworth School, 130, Centre Street, Danvers Center, Danvers, Essex County, Massachusetts, 01923-1014, United States

    WADSWORTH VILLAGE, HATHORNE HOUSE #4

    DANVERS, MA 019231400

    Phone: (978) 777-1088

    Fax: (978) 777-3883

    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: 2006-03-15

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
I20060315000711IClinical PsychologistMATBD

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 01923)

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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: 7719281492View full group profile
NameSpecialtyState
Clinical PsychologistMA

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Frequently asked questions

Is DR. MARK SULLIVAN HANSON (PHD) listed with a National Provider Identifier?
Yes — DR. MARK SULLIVAN HANSON (PHD) has NPI 1003984386 on file in the registry.
Would DR. MARK SULLIVAN HANSON (PHD) appear as active to a payer?
You can treat DR. MARK SULLIVAN HANSON (PHD) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with DR. MARK SULLIVAN HANSON (PHD)?
DR. MARK SULLIVAN HANSON (PHD)'s record emphasizes Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. MARK SULLIVAN HANSON (PHD)?
Travel planning: use Danvers, Massachusetts as the reference point for DR. MARK SULLIVAN HANSON (PHD), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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