MRS. MARY THERESA JOHNSON (M.A.) – Mental Health Counselor, NPI 1164516175

MRS. MARY THERESA JOHNSON (M.A.) is a healthcare provider. based in Sturbridge, Massachusetts. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials M.A.. They hold a License No. 1003 (MA). The NPI Number for MRS. MARY THERESA JOHNSON (M.A.) is 1164516175

Main info

Female
Sole Proprietor
28 Years Of Experience
Accepts Medicare Assignment
Name
MRS. MARY THERESA JOHNSON (M.A.)
NPI
1164516175
Phone
(508) 418-6888
Address
258 Main St
Enumeration Date
3 October 2006
Last Update Date
2 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5084186888206
Graduation Year
1998 (28 years ago)
PAC ID
2567802580
Group Practice PAC ID
4082983911
Professional Enrollment ID
I20240424002283
Address ID
MA015661540ST258XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,116 MENTAL HEALTH COUNSELOR in MA

Provider Addresses for MRS. MARY THERESA JOHNSON (M.A.)

  • 258 Main St

    Sturbridge, MA 015661540

    Phone: (508) 418-6888

    Type: Location

  • 338;340, Highland Street, Hammond Heights, Worcester, Worcester County, Massachusetts, 01609, United States

    WORCESTER, MA 01602

    Phone: (508) 752-5880

    Fax: (508) 831-9967

    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: 2024-04-24

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
I20240424002283IMental Health CounselorMATBD

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 01566)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082983911View full group profile
NameSpecialtyState
Clinical Social WorkerMA
Clinical Social WorkerMA
Mental Health CounselorMA
Clinical Social WorkerCT
Clinical Social WorkerMA
Psychiatry, Addiction MedicineNH
P S Y C H I A T R YMA
Marriage And Family TherapistMA
P S Y C H I A T R YMA
Clinical Social WorkerMA

Reviews

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Frequently asked questions

Can I verify MRS. MARY THERESA JOHNSON (M.A.) with an NPI only?
You can start verification with NPI 1164516175 for MRS. MARY THERESA JOHNSON (M.A.), then check state licensing separately.
Is MRS. MARY THERESA JOHNSON (M.A.) listed as active for patients and plans?
The listing shows MRS. MARY THERESA JOHNSON (M.A.) as active in the NPI system.
What healthcare role does MRS. MARY THERESA JOHNSON (M.A.) hold?
Scheduling teams often label MRS. MARY THERESA JOHNSON (M.A.) under Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What address line appears for MRS. MARY THERESA JOHNSON (M.A.)?
MRS. MARY THERESA JOHNSON (M.A.)'s geographic hint is Sturbridge, Massachusetts in our summary view.
Is the information about MRS. MARY THERESA JOHNSON (M.A.) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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