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, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignments
2Medicare enrollment records show Maralissa Sullivan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Fort Wayne, IN 46806
- Reassigned Medicare billing, Indiana enrollment
- 260 clinicians in this Medicare group
Durham, NC 27701
- Reassigned Medicare billing, Indiana enrollment
- 77 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Which organizations bill Medicare for Maralissa Sullivan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Maralissa Sullivan reassigns Medicare benefits to 2 organizations: Bowen Health Inc (Fort Wayne, IN) and Mental Health Specialty Group PA (Durham, NC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Maralissa Sullivan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Maralissa Sullivan accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource 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 18 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
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Bowen Health Inc (NPI 1023668183, Fort Wayne, IN); Mental Health Specialty Group PA (NPI 1801472634, Durham, NC) · CMS Revalidation Reassignment List, October 2026 release
- **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.