MARY J PAYNE (LCPC) – Professional Counselor, NPI 1225585003
Professional Counselor
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13 UNDEFINED NON-PHYSICIAN TYPE (SPECIFY) in ID
Provider Addresses for MARY J PAYNE (LCPC)
702, Sunset Drive, Ontario, Malheur County, Oregon, 97914, United States
ONTARIO, OR 979143121
Phone: (541) 889-9167
Fax: (541) 889-7873
Type: Mailing
824 S Diamond St
Nampa, ID 836865960
Phone: (208) 546-3046
Type: Location
2609, South 10th Avenue, Caldwell, Canyon County, Idaho, 83605, United States
STE 102
CALDWELL, ID 836056816
Phone: (208) 454-2766
Type: Location
702 SUNSET DR
ONTARIO, OR 979143121
Phone: (541) 889-9167
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: 2024-01-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240110004635 | I | Licensed Professional Counselor | ID | TBD |
| I20240119003214 | I | Licensed Professional Counselor | OR | TBD |
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.
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 97914)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | OR | |
| Mental Health Counselor | OR | |
| - | ID | |
| Clinical Social Worker | OR | |
| Clinical Social Worker | OR | |
| - | ID | |
| - | ID | |
| - | OH | |
| Clinical Social Worker | OR | |
| Undefined Non Physician Type (Specify) | OR |
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