AMELIA FAZACKERLEY MT-BC, LMHC
NPI 1790494920
Counselor - Mental Health in Worcester, MA
About Amelia Fazackerley Mt-bc, Lmhc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AMELIA FAZACKERLEY MT-BC, LMHC (NPI 1790494920) is an individual mental health provider in Worcester, Massachusetts, licensed in Massachusetts (LMHC10002923) and active in the NPI registry since November 2022. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Amelia Fazackerley Mt-bc, Lmhc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Amelia Fazackerley reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Taunton, MA 02780
- Reassigned Medicare billing, Massachusetts enrollment
- 689 clinicians in this Medicare group
Durham, NC 27701
- Reassigned Medicare billing, Massachusetts enrollment
- 78 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 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Amelia Fazackerley's NPI number?
The NPI number for Amelia Fazackerley is 1790494920. It was assigned to this individual provider in the NPPES registry on November 16, 2022.
Where is Amelia Fazackerley located?
Amelia Fazackerley practices at 670 W Boylston St, Worcester, MA 01606. The listed phone number is (508) 853-2300.
What is Amelia Fazackerley's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Amelia Fazackerley enrolled in Medicare?
Yes. Amelia Fazackerley is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Amelia Fazackerley's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Amelia Fazackerley reassigns Medicare benefits to 2 organizations: Northeast Health Services, LLC (Taunton, MA) and Mental Health Specialty Group PA (Durham, NC). 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 Amelia Fazackerley'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 Amelia Fazackerley was last updated on August 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Amelia Fazackerley, MT-BC, LMHC · NPI 1790494920
Mental Health provider in Worcester, Massachusetts. Individual provider, active in the CMS NPPES registry since November 16, 2022.
## Identity
- **NPI:** 1790494920 (Entity type: Individual)
- **Enumerated:** November 16, 2022
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** LMHC10002923 (Massachusetts)
- **Sole proprietor:** No
## Practice location
- **Address:** 670 W BOYLSTON ST, Worcester, MA 01606-2092
- **Phone:** (508) 853-2300
## 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): Northeast Health Services, LLC (NPI 1225067481, Taunton, MA); Mental Health Specialty Group PA (NPI 1801472634, Durham, NC) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 5, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1790494920) · Data from the CMS NPPES public registry.