SUSANNAH TULLY (NPI# 1558754200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558754200 |
| Entity Type | Individual |
| Full Name | SUSANNAH TULLY |
| Other Name | SUSANNAH TULLY |
| Credential | M. ED. |
| Practice Address |
470 Forest Avenue 300 Portland ME 04101 |
| Mailing Address |
470 Forrester Avenue 300 Portland ME 04101 |
| Practice Telephone | 2078541030 |
| Mailing Telephone | 2078541030 |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2015-03-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
CC4200 | ME | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | MAINECARE | CC4200 | 01 |
| Street Address |
470 FOREST AVENUE 300 |
| City | PORTLAND |
| State | ME |
| Zip Code | 04101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306450655 | Jocylin Egan | Nurse Practitioner | 442 Congress Street, 2nd Floor, Portland, ME 04101 | 2020-09-03 |
| 1255963559 | Portcity Home Healthcare LLC | In Home Supportive Care | 525 Forest Avenue, Suite 8, Portland, ME 04101 | 2020-02-05 |
| 1578101929 | Mohamed Hassan Mohamed | Student in an Organized Health Care Education/Training Program | 75 Lancaster St Ste 218a, Portland, ME 04101 | 2019-12-17 |
| 1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
| 1093379224 | Alexandra Strawbridge Maurer | Acupuncturist | 50 A Cove Street, Portland, ME 04101 | 2019-04-23 |
| 1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
| 1144733064 | Alixandria Elaine Marie Winchell | Massage Therapist | One City Center, Portland, ME 04101 | 2017-11-14 |
| 1417473638 | Rachel S Schwaner | Occupational Therapist | 78 Danforth Street, Apartment 6, Portland, ME 04101 | 2017-08-18 |
| 1023538154 | Derina Boothroyd | Audiologist-Hearing Aid Fitter | 985 Forest Ave., Portland, ME 04101 | 2017-06-20 |
| 1881123297 | Mark Mccullough | Social Worker | 57 Exchange Street, Suite 403, Portland, ME 04101 | 2017-06-08 |
| Find all providers in zip 04101 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013373 | Ruth Tessema | Counselor | 2120 Ne 166th Dr, Portland, OR 97230-5558 | 2020-11-03 |
| 1629675582 | Michelle Robydek | Counselor | 103 Rindle Bluff Dr, Portland, MI 48875-9435 | 2020-10-05 |
| 1326656240 | Donald Marks | Counselor | 7901 Se Powell Blvd Ste B251, Portland, OR 97206-2314 | 2020-07-16 |
| 1922624782 | Marc Francis Otto | Counselor | 215 Ne 60th Ave, Portland, OR 97213-3721 | 2020-06-17 |
| 1013532183 | Monica Grace Vanek | Counselor | 4248 Ne Skidmore St, Portland, OR 97218-1753 | 2020-06-14 |
| 1427670355 | Leonore Elisabeth Licht-miller | Counselor | 1455 Sw Stephenson St, Portland, OR 97219-8222 | 2020-05-14 |
| 1821624834 | Kara Pierce | Counselor | 5640 Ne 7th Ave, Portland, OR 97211-3249 | 2020-03-21 |
| 1932746302 | Lynne Coon Counseling, LLC | Counselor | 1340 Sw Bertha Blvd Ste 202, Portland, OR 97219-2096 | 2019-12-04 |
| 1912554809 | Genevieve Pritchard | Counselor | 4150 N Williams Ave Apt 409, Portland, OR 97217-2970 | 2019-08-24 |
| 1407312465 | Jor-el Zajatz | Counselor | 12 Se 14th Ave Ste 105, Portland, OR 97214-1404 | 2019-02-14 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.