Mrs Mary Ellen Souder, LPCC-S in Mansfield, OH

Mrs Mary Ellen Souder, LPCC-S is a medicare enrolled "Counselor - Professional" provider in Mansfield, Ohio. Her current practice location is 151 Marion Ave, Mansfield, Ohio. You can reach out to her office (for appointments etc.) via phone at (419) 774-9969.

Mrs Mary Ellen Souder is licensed to practice in Ohio (license number E0007898-SUPV) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1124247499.

Contact Information

	Mrs Mary Ellen Souder, LPCC-S
	151 Marion Ave, Mansfield, OH 44903-2223
	(419) 774-9969
	(419) 756-5642

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Mary Ellen Souder
Gender	Female
Speciality	Counselor - Professional
Location	151 Marion Ave, Mansfield, Ohio
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1124247499
Provider Enumeration Date: 04/25/2007
Last Update Date: 05/03/2021

Medicare PECOS Information:

PECOS PAC ID: 9335588383
Enrollment ID: I20240423003965

Medical Identifiers

Medical identifiers for Mrs Mary Ellen Souder such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1124247499	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
106H00000X	Marriage & Family Therapist	(* (Not Available))	Secondary
101YP2500X	Counselor - Professional	E0007898-SUPV (Ohio)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Mary Ellen Souder allows following entities to bill medicare on her behalf.

Entity Name	Family Life Counseling & Psychiatric Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1598862641 PECOS PAC ID: 0749353464 Enrollment ID: O20080714000402

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Mary Ellen Souder is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Mary Ellen Souder, LPCC-S 235 Bartley Ave, Mansfield, OH 44903-2005 Ph: (419) 565-1314	Mrs Mary Ellen Souder, LPCC-S 151 Marion Ave, Mansfield, OH 44903-2223 Ph: (419) 774-9969

Reviews and Comments

Counselor in Mansfield, OH

Elizabeth A Dean, CDCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 680 Park Ave W, Mansfield, OH 44906 Phone: 419-528-5993 Fax: 568-560-5483
Gary Lee Russell, LPCC-S, LICDC Counselor Medicare: Not Enrolled in Medicare Practice Location: 151 Marion Ave, Mansfield, OH 44903 Phone: 419-774-9969
Debora Van Romer, LPC Counselor Medicare: Medicare Enrolled Practice Location: 151 Marion Ave, Mansfield, OH 44903 Phone: 419-774-9969 Fax: 419-756-5642
Wesley Kyser, LISW-S, LICDC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2 Smith Ave, Mansfield, OH 44905 Phone: 419-982-2400
Stevanie Brown, LSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 151 Marion Ave, Mansfield, OH 44903 Phone: 419-774-9969
Aloys Kamwithi, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 270 Sterkel Blvd, Mansfield, OH 44907 Phone: 419-756-1133 Fax: 419-756-7456
Jessica L Luttrell, Counselor Medicare: Not Enrolled in Medicare Practice Location: 780 Park Ave W, Mansfield, OH 44906 Phone: 419-709-8103

Mrs Mary Ellen Souder, LPCC-S - Medicare Counselor in Mansfield, OH