MS. MARY ANN SUMMERLIN LPCA
NPI 1487062824
Counselor - Mental Health in Jacksonville, NC
About Ms. Mary Ann Summerlin Lpca NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. MARY ANN SUMMERLIN LPCA (NPI 1487062824) is an individual mental health provider in Jacksonville, North Carolina, licensed in North Carolina (11015) and active in the NPI registry since July 2014. She is enrolled in Medicare PECOS and is a graduate of Other (2014).
NPPES Registry Identity
Specialties & Licenses 2
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)
Ms. Mary Ann Summerlin Lpca is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mary Summerlin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Miami, FL 33130
- Reassigned Medicare billing, North Carolina enrollment
- 712 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 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
JACKSONVILLE, NC 28540
JACKSONVILLE, NC 28540
JACKSONVILLE, NC 28540
JACKSONVILLE, NC 28540
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 Mary Summerlin's NPI number?
The NPI number for Mary Summerlin is 1487062824. It was assigned to this individual provider in the NPPES registry on July 29, 2014.
Where is Mary Summerlin located?
Mary Summerlin practices at 201 New Bridge St Suite 105, Jacksonville, NC 28540. The listed phone number is (910) 336-4958.
What is Mary Summerlin's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Mary Summerlin enrolled in Medicare?
Yes. Mary Summerlin is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Mary Summerlin's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Summerlin reassigns Medicare benefits to Grow Healthcare Group PA (Miami, FL). The 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 Mary Summerlin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Mary Summerlin accept?
Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 4 other insurers list Mary Summerlin 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 Mary Summerlin was last updated on February 1, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Ms. Mary Ann Summerlin, LPCA · NPI 1487062824
Mental Health provider in Jacksonville, North Carolina. Individual provider, active in the CMS NPPES registry since July 29, 2014.
## Identity
- **NPI:** 1487062824 (Entity type: Individual)
- **Enumerated:** July 29, 2014
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 11015 (North Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 201 NEW BRIDGE ST, SUITE 105, Jacksonville, NC 28540-4736
- **Phone:** (910) 336-4958 · **Fax:** (910) 333-9742
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Grow Healthcare Group PA (NPI 1245845932, Miami, FL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2014
## Record status
- **NPPES last updated:** February 1, 2017
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Source: [NPI Profile](https://npiprofile.com/npi/1487062824) · Data from the CMS NPPES public registry.