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MARISA ANDERSON
NPI 1003367152
Counselor - Mental Health in Cambridge, MA

Active since October 24, 2016Opted out of Medicare · through Sep 3, 2027
1158 MASSACHUSETTS AVE FL 3, CAMBRIDGE, MA 02138(857) 314-0554 Get Directions Write a Review

NPPES record last updated: January 22, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 22, 2019, Mar 17, 2018, Oct 29, 2017 and 1 more (4 updates tracked since 2016).

About Marisa Anderson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARISA ANDERSON (NPI 1003367152) is an individual mental health provider in Cambridge, Massachusetts, licensed in Massachusetts (10786) and active in the NPI registry since October 2016. She has opted out of Medicare through September 3, 2027 and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1003367152
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMARISA ANDERSON
Location Address1158 MASSACHUSETTS AVE FL 3Cambridge, MA 02138-5205
Mailing Address1158 Massachusetts Ave Fl 3Cambridge, MA 02138-5205 · (857) 314-0554
Phone(857) 314-0554
Sole ProprietorYes
Enumeration DateOctober 24, 2016
Last NPPES UpdateJanuary 22, 20194 updates tracked since enumeration
✔ NPI 1003367152 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in MA · 10786
1158 MASSACHUSETTS AVE FL 3, Cambridge, MA 02138
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Secondary Practice Locations 2

Location 1270 Pleasant St, Apt. 124Watertown, MA 02472-2470 · Phone (860) 985-6269
Location 286 Baker Avenue Ext Ste 100Concord, MA 01742-2132 · Phone (978) 369-1113 ext. 4116

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Marisa Anderson has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 3, 2025 through September 3, 2027.

Opt-Out Effective DateSeptember 3, 2025
Opt-Out In Effect ThroughSeptember 3, 2027Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marisa Anderson's NPI number?

The NPI number for Marisa Anderson is 1003367152. It was assigned to this individual provider in the NPPES registry on October 24, 2016.

Where is Marisa Anderson located?

Marisa Anderson practices at 1158 Massachusetts Ave Fl 3, Cambridge, MA 02138. The listed phone number is (857) 314-0554.

What is Marisa Anderson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Marisa Anderson enrolled in Medicare?

No. Marisa Anderson has opted out of Medicare through September 3, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Marisa Anderson was last updated on January 22, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.