DR. MARY KAY GLEESON (PH.D.) – Clinical Psychologist, NPI 1912074071

DR. MARY KAY GLEESON (PH.D.) is a healthcare provider. based in Lynnfield, Massachusetts. specializing in Clinical Psychologist. They hold the professional credentials PH.D.. They hold a License No. 7568 (MA). The NPI Number for DR. MARY KAY GLEESON (PH.D.) is 1912074071

Main info

Female
Sole Proprietor
30 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARY KAY GLEESON (PH.D.)
NPI
1912074071
Phone
(781) 224-4120
Address
7 KIMBALL LANE
Enumeration Date
30 November 2006
Last Update Date
4 November 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7816460500
Graduation Year
1996 (30 years ago)
PAC ID
9537151402
Group Practice PAC ID
5991763823
Professional Enrollment ID
I20161221001744
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for DR. MARY KAY GLEESON (PH.D.)

  • 7, Kimball Lane, Lynnfield, Essex County, Massachusetts, 01940, United States

    BUILDING E, SUITE 3B

    LYNNFIELD, MA 019402617

    Phone: (781) 224-4120

    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: 2016-12-21

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
I20161221001744IClinical 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

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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 01940)

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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: 5991763823View full group profile

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Frequently asked questions

What NPI should I save for DR. MARY KAY GLEESON (PH.D.)?
Save NPI 1912074071 if you need a stable reference for DR. MARY KAY GLEESON (PH.D.).
Is DR. MARY KAY GLEESON (PH.D.)'s NPI currently valid?
The extract we use shows DR. MARY KAY GLEESON (PH.D.) as active.
What does DR. MARY KAY GLEESON (PH.D.) treat or focus on?
Patients typically see DR. MARY KAY GLEESON (PH.D.) under the specialty Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Does DR. MARY KAY GLEESON (PH.D.) practice in Massachusetts?
You will see Lynnfield, Massachusetts on file for DR. MARY KAY GLEESON (PH.D.) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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