MALLORY WETHERINGTON LPC
NPI 1053050443
Counselor - Professional in Anchorage, AK
About Mallory Wetherington Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MALLORY WETHERINGTON LPC (NPI 1053050443) is an individual professional provider in Anchorage, Alaska, licensed in Alaska (177739) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2017).
NPPES Registry Identity
Specialties & Licenses 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mallory Wetherington Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Mallory Wetherington reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Anchorage, AK 99508
- Reassigned Medicare billing, Texas enrollment
- 459 clinicians in this Medicare group
Anchorage, AK 99508
- Reassigned Medicare billing, Alaska enrollment
- 5 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ANCHORAGE, AK 99508
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 Mallory Wetherington's NPI number?
The NPI number for Mallory Wetherington is 1053050443. It was assigned to this individual provider in the NPPES registry on June 2, 2022.
Where is Mallory Wetherington located?
Mallory Wetherington practices at 4320 Diplomacy Dr, Anchorage, AK 99508. The listed phone number is (907) 729-3300.
What is Mallory Wetherington's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Mallory Wetherington enrolled in Medicare?
Yes. Mallory Wetherington is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Mallory Wetherington's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mallory Wetherington reassigns Medicare benefits to 2 organizations: Southcentral Foundation (Anchorage, AK) and Borealis Life, LLC (Anchorage, AK). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mallory Wetherington's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Mallory Wetherington accept?
Health plans from Premera Blue Cross Blue Shield of Alaska list Mallory Wetherington as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Mallory Wetherington was last updated on January 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.
# Mallory Wetherington, LPC · NPI 1053050443
Professional provider in Anchorage, Alaska. Individual provider, active in the CMS NPPES registry since June 2, 2022.
## Identity
- **NPI:** 1053050443 (Entity type: Individual)
- **Enumerated:** June 2, 2022
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 177739 (Alaska)
- **Sole proprietor:** No
## Practice location
- **Address:** 4320 DIPLOMACY DR, Anchorage, AK 99508-5925
- **Phone:** (907) 729-3300
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Southcentral Foundation (NPI 1306499710, Anchorage, AK); Borealis Life, LLC (NPI 1700591831, Anchorage, AK) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** January 29, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1053050443) · Data from the CMS NPPES public registry.