MARY ELIZABETH MARESH (PSYD) – Psychologist, NPI 1104329234

MARY ELIZABETH MARESH (PSYD) is a healthcare provider. based in Minneapolis, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSYD. They hold a License No. LP6224 (MN). The NPI Number for MARY ELIZABETH MARESH (PSYD) is 1104329234

Main info

Female
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
MARY ELIZABETH MARESH (PSYD)
NPI
1104329234
Phone
(612) 596-9438
Address
2215 E LAKE ST
Enumeration Date
15 March 2018
Last Update Date
10 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6125969438
Graduation Year
2015 (11 years ago)
PAC ID
0446684138
Group Practice PAC ID
7911892849
Professional Enrollment ID
I20200106002654
Address ID
MN554074385MI2215XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness85
Years active:8State licenses:1Digital endpointsOther names

1,110 CLINICAL PSYCHOLOGIST in MN

Provider Addresses for MARY ELIZABETH MARESH (PSYD)

  • 2215 E LAKE ST

    MINNEAPOLIS, MN 554074385

    Phone: (612) 596-9438

    Type: Mailing

  • 1801, Nicollet Avenue, Stevens Square - Loring Heights, Minneapolis, Hennepin County, Minnesota, 55403, United States

    MINNEAPOLIS, MN 554033791

    Phone: (612) 596-9438

    Type: Mailing

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: 2020-01-06

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
I20200106002654IClinical PsychologistMNTBD

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 55407)

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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: 7911892849View full group profile
NameSpecialtyState
Marriage And Family TherapistCA
-MN
Clinical Social WorkerMN
Mental Health CounselorMN
Nurse PractitionerMN
-MN
-MN
Clinical Social WorkerMN
Clinical Social WorkerMN
Nurse PractitionerMN

Reviews

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Frequently asked questions

How is MARY ELIZABETH MARESH (PSYD) identified in CMS data?
CMS-hosted NPPES data lists MARY ELIZABETH MARESH (PSYD) with NPI 1104329234.
Is MARY ELIZABETH MARESH (PSYD) listed as active for patients and plans?
The listing shows MARY ELIZABETH MARESH (PSYD) as active in the NPI system.
What healthcare role does MARY ELIZABETH MARESH (PSYD) hold?
Scheduling teams often label MARY ELIZABETH MARESH (PSYD) under Psychologist. Clinical services aligned with this taxonomy classification.
What address line appears for MARY ELIZABETH MARESH (PSYD)?
MARY ELIZABETH MARESH (PSYD)'s geographic hint is Minneapolis, Minnesota in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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