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MR. JOHN ANTHONY SOUTHWORTH LMHC
NPI 1457515199
Counselor - Mental Health in Malta, NY

Active since July 11, 2008PECOS Enrolled
2452 US ROUTE 9, SUITE 206, MALTA, NY 12020(518) 292-5433(518) 899-4930 Get Directions Write a Review

NPPES record last updated: March 13, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 13, 2026, May 21, 2025, Apr 7, 2025 (3 updates tracked since 2025).

About Mr. John Anthony Southworth Lmhc NPPES

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

MR. JOHN ANTHONY SOUTHWORTH LMHC (NPI 1457515199) is an individual mental health provider in Malta, New York, licensed in New York (001436-1) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS and is a graduate of Other (2003).

NPPES Registry Identity

NPI1457515199
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMR. JOHN ANTHONY SOUTHWORTHCredential: LMHC
Location Address2452 US ROUTE 9, SUITE 206Malta, NY 12020
Mailing Address2452 Us Route 9, Suite 206Malta, NY 12020 · (518) 292-5433 · Fax (518) 899-4930
Phone(518) 292-5433
Fax(518) 899-4930
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateJuly 11, 2008
Last NPPES UpdateMarch 13, 20263 updates tracked since enumeration
NPPES CertifiedMarch 13, 2026
✔ NPI 1457515199 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 NY · 001436-1
2452 US ROUTE 9, Malta, NY 12020
Open in Google Maps ↗

Other Identifiers 1

Medicaid00318805NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. John Anthony Southworth Lmhc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3173032885
PECOS Enrollment IDI20250604001022
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show John Southworth reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Parsons Child And Family Center
22 mi
Custodial Care Facility
60 ACADEMY RD
Albany, NY 12208
  • Reassigned Medicare billing, New York enrollment
  • 77 clinicians in this Medicare group
NPI 1922171305 (518) 426-2600
Boston Children's Health Physicians, LLP
129 mi
Pediatrics
19 SKYLINE DR OFC 1N-D06
Hawthorne, NY 10532
  • Reassigned Medicare billing, New York enrollment
  • 511 clinicians in this Medicare group
NPI 1467454967 (914) 594-2100

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 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HALEY MARIE GATTI RN
Registered Nurse
2452 US ROUTE 9, SUITE 206
MALTA, NY 12020
Saratoga County (518) 292-5433
ADAM SMATKO LMSW
Social Worker (Clinical)
2452 US ROUTE 9, SUITE 206
MALTA, NY 12020
Saratoga County (518) 292-5433

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 John Southworth's NPI number?

The NPI number for John Southworth is 1457515199. It was assigned to this individual provider in the NPPES registry on July 11, 2008.

Where is John Southworth located?

John Southworth practices at 2452 Us Route 9 Suite 206, Malta, NY 12020. The listed phone number is (518) 292-5433.

What is John Southworth's specialty?

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

Is John Southworth enrolled in Medicare?

Yes. John Southworth is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for John Southworth's services?

According to the CMS Revalidation Reassignment List (October 2026 release), John Southworth reassigns Medicare benefits to 2 organizations: Parsons Child And Family Center (Albany, NY) and Boston Children's Health Physicians, LLP (Hawthorne, NY). 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 John Southworth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for John Southworth was last updated on March 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.