Mary Jo Mettler, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

130223 Issued in AK

Practice address

508 Upland St
Kenai, AK 99611-8026

Phone

(907) 335-7300

NPI assigned

Aug 13, 2018

Last updated

Aug 12, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 3, 2024 through Jan 3, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

• Northern Lighthouse Day Center

  • Respite Care
  • Anchorage, AK
  • NPI 1003035627
  Authorized official Same address or phone
• Northern Lighthouse Dba Northern Lighthouse Day Center

  • Respite Care
  • Soldotna, AK
  • NPI 1659601409
  Authorized official Same address or phone

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1437638178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3114",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996113114",
            "telephone_number": "907-398-2939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 UPLAND ST",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996118026",
            "telephone_number": "907-335-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36028 Dayspring St",
            "address_purpose": "LOCATION",
            "city": "Soldotna",
            "state": "AK",
            "postal_code": "996698611",
            "country_code": "US",
            "telephone_number": "907-398-2939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "METTLER",
        "first_name": "MARY JO",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AK",
            "license": "130223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1714851",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1757636",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gehret Mitchell Medcoff
• Medical Network of Alaska, LLC (Capstone Clinic)
• Mark R Mencel, PA-C
• Ann Marie Mercer, FNP
• Heidi Beth Metteer, SLPA
• Karey Mewbourn, APRN
• Shana Mickenham, LPC, CDCS, BHP
• Rhonda Lynn Miles
• Andrea L. Miller
• Linda Apollonia Miller

• Professional Counselor in Kenai, AK
• Providers in Kenai, AK by specialty
• Professional Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.