MRS. MARY ELLEN SOUDER (LPCC-S) – Professional Counselor, NPI 1124247499

MRS. MARY ELLEN SOUDER (LPCC-S) is a healthcare provider. based in Mansfield, Ohio. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPCC-S. They hold a License No. E0007898-SUPV (OH). The NPI Number for MRS. MARY ELLEN SOUDER (LPCC-S) is 1124247499

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
MRS. MARY ELLEN SOUDER (LPCC-S)
NPI
1124247499
Phone
(419) 774-9969
Address
151 MARION AVE
Enumeration Date
25 April 2007
Last Update Date
3 May 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4197749969
Graduation Year
2006 (20 years ago)
PAC ID
9335588383
Group Practice PAC ID
0749353464
Professional Enrollment ID
I20240423003965
Address ID
OH449032223MA151XXAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,538 MENTAL HEALTH COUNSELOR in OH

Provider Addresses for MRS. MARY ELLEN SOUDER (LPCC-S)

  • 151 MARION AVE

    MANSFIELD, OH 449032223

    Phone: (419) 774-9969

    Fax: (419) 756-5642

    Type: Mailing

  • 235 BARTLEY AVE

    MANSFIELD, OH 449032005

    Phone: (419) 565-1314

    Fax: (419) 756-5642

    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: 2024-04-23

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
I20240423003965IMental Health CounselorOHTBD

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 44903)

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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: 0749353464View full group profile
NameSpecialtyState
-OH
Mental Health CounselorOH
-OH
Mental Health CounselorOH
Mental Health CounselorOH
Mental Health CounselorOH
Mental Health CounselorOH
Clinical Social WorkerOH
Mental Health CounselorOH
Marriage And Family TherapistOH

Reviews

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Frequently asked questions

Can I cross-check MRS. MARY ELLEN SOUDER (LPCC-S) using NPI 1124247499?
NPI 1124247499 belongs to MRS. MARY ELLEN SOUDER (LPCC-S); compare other details if you need extra assurance.
Is MRS. MARY ELLEN SOUDER (LPCC-S) still an active registrant?
MRS. MARY ELLEN SOUDER (LPCC-S) carries an active NPI according to the public dataset.
What kind of doctor is MRS. MARY ELLEN SOUDER (LPCC-S)?
MRS. MARY ELLEN SOUDER (LPCC-S) is associated with Professional Counselor in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for MRS. MARY ELLEN SOUDER (LPCC-S)?
Travel planning: use Mansfield, Ohio as the reference point for MRS. MARY ELLEN SOUDER (LPCC-S), then confirm.
What does 3 location(s) imply?
3 practice locations appear in the available data.

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