Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Maralissa A Sullivan, MS

Individual provider Mental Health Counselor · NPI 1700130267

Maralissa A Sullivan, MS is a Mental Health Counselor in Fort Wayne, Indiana. Qualified in 2010, 16 years ago. Practices with Mental Health Specialty Group PA, a 679-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
16
Licensed in
IN
In the registry since
2012
What do these letters mean?
MS — Master of Science
A graduate science degree.

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Practice location PO Box

The provider listed a PO Box rather than a street location, so this is not a walk-in address.

PO Box 9012
Fort Wayne, IN 46899-9012
Phone: (260) 676-0074
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 39002971A (IN)

Record details

NPI number1700130267
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS
Sole proprietorYes
NPI enumeratedNovember 6, 2012
Last updated in NPPESApril 21, 2025
Certification dateApril 21, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Mental Health Specialty Group Pa — 679 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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