MRS. GRETE ANTONIA HEATHERLY (LPCC-S) – Professional Counselor, NPI 1295007409

MRS. GRETE ANTONIA HEATHERLY (LPCC-S) is a healthcare provider. based in Canton, Ohio. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPCC-S. They hold a License No. E.1100472-SUPV (OH). The NPI Number for MRS. GRETE ANTONIA HEATHERLY (LPCC-S) is 1295007409

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
MRS. GRETE ANTONIA HEATHERLY (LPCC-S)
NPI
1295007409
Phone
(330) 453-8252
Address
1341 MARKET AVE N
Enumeration Date
2 February 2012
Last Update Date
1 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3308218407
Graduation Year
2012 (14 years ago)
PAC ID
1850741893
Group Practice PAC ID
9335110824
Professional Enrollment ID
I20240103001380
Address ID
OH446014686AL1207XSTXX403
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:14State licenses:1Digital endpointsOther names

2,538 MENTAL HEALTH COUNSELOR in OH

Provider Addresses for MRS. GRETE ANTONIA HEATHERLY (LPCC-S)

  • 1341 MARKET AVE N

    CANTON, OH 447142605

    Phone: (330) 453-8252

    Fax: (330) 453-6716

    Type: Location

  • 625 CLEVELAND AVE NW

    CANTON, OH 447021805

    Phone: (330) 455-0374

    Fax: (330) 453-6716

    Type: Mailing

  • 1207 W STATE ST STE M

    ALLIANCE, OH 446014686

    Phone: (330) 821-8407

    Fax: (330) 821-8506

    Type: Location

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: 2024-01-03

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
I20240103001380IMental 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 44714)

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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: 9335110824View full group profile
NameSpecialtyState
Nurse PractitionerOH
-OH
Mental Health CounselorOH
Nurse PractitionerOH
-OH
Mental Health CounselorOH
-OH
Mental Health CounselorOH
Nurse PractitionerOH
Mental Health CounselorOH

Reviews

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Frequently asked questions

What unique ID ties claims to MRS. GRETE ANTONIA HEATHERLY (LPCC-S)?
NPI 1295007409 is assigned to MRS. GRETE ANTONIA HEATHERLY (LPCC-S) under the national enumeration system.
Does this profile mean MRS. GRETE ANTONIA HEATHERLY (LPCC-S) is currently active?
Yes — MRS. GRETE ANTONIA HEATHERLY (LPCC-S) appears active in the national provider directory.
Does MRS. GRETE ANTONIA HEATHERLY (LPCC-S) list a primary specialty?
If you are matching referrals, note Professional Counselor for MRS. GRETE ANTONIA HEATHERLY (LPCC-S). Clinical services aligned with this taxonomy classification.
Does MRS. GRETE ANTONIA HEATHERLY (LPCC-S) practice in Ohio?
You will see Canton, Ohio on file for MRS. GRETE ANTONIA HEATHERLY (LPCC-S) alongside any extra practice locations.
What if Canton, Ohio seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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