MS. MARYLOU DONNELLY MA
NPI 1326130576
Psychologist in Sebastopol, CA

Active since September 28, 2006Opted out of Medicare · through Jan 1, 2028
105 MORRIS ST STE 180, SEBASTOPOL, CA 95472(707) 535-9879 Get Directions Write a Review

NPPES record last updated: April 14, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ms. Marylou Donnelly Ma NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. MARYLOU DONNELLY MA (NPI 1326130576) is an individual psychologist in Sebastopol, California, licensed in California (MFT22156) and active in the NPI registry since September 2006. She has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1326130576
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameMS. MARYLOU DONNELLYCredential: MA
Location Address105 MORRIS ST STE 180Sebastopol, CA 95472-3835
Mailing Address105 Morris St Ste 180Sebastopol, CA 95472-3835 · (707) 535-9879
Sole ProprietorNo
Enumeration DateSeptember 28, 2006
Last NPPES UpdateApril 14, 2020
NPPES CertifiedApril 14, 2020
NPI 1326130576 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in CA · MFT22156
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
105 MORRIS ST STE 180, Sebastopol, CA 95472

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Ms. Marylou Donnelly Ma has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Marriage & Family Therapist
105 MORRIS ST STE 180
SEBASTOPOL, CA 95472

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marylou Donnelly's NPI number?

The NPI number for Marylou Donnelly is 1326130576. It was assigned to this individual provider in the NPPES registry on September 28, 2006.

Where is Marylou Donnelly located?

Marylou Donnelly practices at 105 Morris St Ste 180, Sebastopol, CA 95472. The listed phone number is (707) 535-9879.

What is Marylou Donnelly's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Marylou Donnelly enrolled in Medicare?

No. Marylou Donnelly has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Marylou Donnelly was last updated on April 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.