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THERESA DOUB LPC
NPI 1225614480
Counselor - Mental Health in Williamsport, MD

Active since March 18, 2021Opted out of Medicare · through Aug 20, 2026
10703 CONNOR DR, WILLIAMSPORT, MD 21795(410) 305-9556 Get Directions Write a Review

NPPES record last updated: June 20, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 20, 2023, Jun 15, 2023, Aug 26, 2021 and 1 more (4 updates tracked since 2021).

About Theresa Doub Lpc NPPES

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

THERESA DOUB LPC (NPI 1225614480) is an individual mental health provider in Williamsport, Maryland, licensed in Maryland (LC13693) and active in the NPI registry since March 2021. She has opted out of Medicare through August 20, 2026.

NPPES Registry Identity

NPI1225614480
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameTHERESA DOUBCredential: LPC
Location Address10703 CONNOR DRWilliamsport, MD 21795-3176
Mailing Address10703 Connor DrWilliamsport, MD 21795-3176 · (410) 305-9556
Phone(410) 305-9556
Sole ProprietorYes
Enumeration DateMarch 18, 2021
Last NPPES UpdateJune 20, 20234 updates tracked since enumeration
NPPES CertifiedJune 20, 2023
✔ NPI 1225614480 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 MD · LC13693
10703 CONNOR DR, Williamsport, MD 21795
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Theresa Doub Lpc 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 August 20, 2024 through August 20, 2026.

Opt-Out Effective DateAugust 20, 2024
Opt-Out In Effect ThroughAugust 20, 2026Opt-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 Theresa Doub's NPI number?

The NPI number for Theresa Doub is 1225614480. It was assigned to this individual provider in the NPPES registry on March 18, 2021.

Where is Theresa Doub located?

Theresa Doub practices at 10703 Connor Dr, Williamsport, MD 21795. The listed phone number is (410) 305-9556.

What is Theresa Doub's specialty?

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

Is Theresa Doub enrolled in Medicare?

No. Theresa Doub has opted out of Medicare through August 20, 2026. 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 Theresa Doub was last updated on June 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.