Mary Ellen Souder, LPCC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E0007898-SUPV Issued in OH

Practice address

151 Marion Ave
Mansfield, OH 44903-2223

Phone

(419) 774-9969

Fax

(419) 756-5642

NPI assigned

Apr 25, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Family Life Counseling and Psychiatric ServicesGroup PAC ID 0749353464, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Life Counseling & Psychiatric Services

  • Mental Health Counselor
  • Mansfield, OH
  • NPI 1598862641
  Medicare reassignment Care Compare group NPD
• Family Life Counseling & Psychiatric Services

  • Addiction (Substance Use Disorder) Counselor
  • Mansfield, OH
  • NPI 1669731246
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1124247499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 BARTLEY AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032005",
            "telephone_number": "419-565-1314",
            "fax_number": "419-756-5642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 MARION AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032223",
            "telephone_number": "419-774-9969",
            "fax_number": "419-756-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUDER",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E0007898-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew J Sommer, D.C.
• Beth Ann Sommers-Souder, MSW, LISW-S
• Susana Tremocha Sorensen
• Emily M. Sorrenti
• Antonio Sortino, M.D.
• Soulace Group LLC
• Sheila South, NP
• Teresa Ann Sparks
• Jill A Spearman Macklin, LSW
• Kimberly Sue Spears

• Professional Counselor in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.