MARALISSA A SULLIVAN MS
NPI 1700130267
Counselor - Mental Health in Fort Wayne, IN
About Maralissa A Sullivan Ms NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARALISSA A SULLIVAN MS (NPI 1700130267) is an individual mental health provider in Fort Wayne, Indiana, licensed in Indiana (39002971A) and active in the NPI registry since November 2012. She is enrolled in Medicare PECOS and is a graduate of Other (2010).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Maralissa A Sullivan Ms is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
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 Maralissa Sullivan's NPI number?
The NPI number for Maralissa Sullivan is 1700130267. It was assigned to this individual provider in the NPPES registry on November 6, 2012.
Where is Maralissa Sullivan located?
Maralissa Sullivan practices at PO Box 9012, Fort Wayne, IN 46899. The listed phone number is (260) 676-0074.
What is Maralissa Sullivan's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Maralissa Sullivan enrolled in Medicare?
Yes. Maralissa Sullivan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
What insurance does Maralissa Sullivan accept?
Health plans from UnitedHealthcare list Maralissa Sullivan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Maralissa Sullivan was last updated on April 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.
# Maralissa A Sullivan, MS · NPI 1700130267
Mental Health provider in Fort Wayne, Indiana. Individual provider, active in the CMS NPPES registry since November 6, 2012.
## Identity
- **NPI:** 1700130267 (Entity type: Individual)
- **Enumerated:** November 6, 2012
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 39002971A (Indiana)
- **Sole proprietor:** Yes
## Practice location
- **Address:** PO BOX 9012, Fort Wayne, IN 46899-9012
- **Phone:** (260) 676-0074
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Medical school:** Other, class of 2010
## Record status
- **NPPES last updated:** April 21, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1700130267) · Data from the CMS NPPES public registry.