TERESA LYNN MALLWITZ (MA, LPC, LCPC, CAAD) – Professional Counselor, NPI 1548303456

TERESA LYNN MALLWITZ (MA, LPC, LCPC, CAAD) is a healthcare provider. based in South portland, Maine. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MA, LPC, LCPC, CAAD. They hold a License No. 6401008704 (MI). The NPI Number for TERESA LYNN MALLWITZ (MA, LPC, LCPC, CAAD) is 1548303456

Main info

Female
Sole Proprietor
24 Years Of Experience
Name
TERESA LYNN MALLWITZ (MA, LPC, LCPC, CAAD)
NPI
1548303456
Phone
(231) 534-5505
Address
963 HIGHLAND AVE
Enumeration Date
14 February 2007
Last Update Date
3 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2002 (24 years ago)
PAC ID
4688183999
Professional Enrollment ID
I20250529003359
Address ID
ME040920000WE1XXXXPLZX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience76
Completeness75
Years active:19State licenses:2Digital endpointsOther names

362 MENTAL HEALTH COUNSELOR in ME

Provider Addresses for TERESA LYNN MALLWITZ (MA, LPC, LCPC, CAAD)

  • 963 HIGHLAND AVE

    SOUTH PORTLAND, ME 04106

    Phone: (231) 534-5505

    Type: Mailing

  • 11 Baxter Blvd Fl 2

    Portland, ME 041011801

    Phone: (603) 883-0005

    Type: Location

  • 66 Baribeau Dr

    Brunswick, ME 040113230

    Phone: (207) 373-6991

    Fax: (207) 373-6080

    Type: Location

  • 622 PARKER HEAD RD

    PHIPPSBURG, ME 045624586

    Phone: (231) 534-5505

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-05-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250529003359IMental Health CounselorMETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 04106)

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Reviews

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Frequently asked questions

What is the standard ID for TERESA LYNN MALLWITZ (MA, LPC, LCPC, CAAD) in the U.S.?
In the U.S., TERESA LYNN MALLWITZ (MA, LPC, LCPC, CAAD) is identified by NPI 1548303456.
Is TERESA LYNN MALLWITZ (MA, LPC, LCPC, CAAD)'s NPI status active today?
Active status means TERESA LYNN MALLWITZ (MA, LPC, LCPC, CAAD)'s NPI record is not deactivated in the public file.
Which specialty label fits TERESA LYNN MALLWITZ (MA, LPC, LCPC, CAAD)?
NPPES ties TERESA LYNN MALLWITZ (MA, LPC, LCPC, CAAD) to Professional Counselor in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to TERESA LYNN MALLWITZ (MA, LPC, LCPC, CAAD)?
TERESA LYNN MALLWITZ (MA, LPC, LCPC, CAAD) shows a connection to South Portland, Maine in registry-derived data.
Can I export TERESA LYNN MALLWITZ (MA, LPC, LCPC, CAAD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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