Jacob M Mecca-Guillien, SAC-IT, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

8241-125 Issued in WI

Practice address

400 Bay View Rd Ste C
Mukwonago, WI 53149-1770

Phone

(622) 789-1191

NPI assigned

Nov 8, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cornerstone Counseling Services IncGroup PAC ID 1456256023, 338 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cornerstone Counseling Services, Inc

  dba LifeStance Health

  • Mental Health Counselor
  • Brookfield, WI
  • NPI 1033127246

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1033687090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 BAY VIEW RD STE C",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531491770",
            "telephone_number": "622-789-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BAY VIEW RD STE C",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531491770",
            "telephone_number": "622-789-1191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1610 Miller Park Way",
            "address_purpose": "LOCATION",
            "city": "West Milwaukee",
            "state": "WI",
            "postal_code": "532143604",
            "country_code": "US",
            "telephone_number": "414-939-7556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MECCA-GUILLIEN",
        "first_name": "JACOB",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "SAC-IT, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-08",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": "4208-226",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "18715-130",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "8241-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler McKeever
• Lauren Kay McLeod
• Katelyn Marie McNamara, LPC
• Pamela Ann McWilliams, D.D.S.
• Laura Meagher, M.D.
• Medical Eye Associates, S.C.
• Steven C. Meisner, M.D.
• Noel Menghe
• Linda Joy Meyer, DO
• Miller Pharmacy, Inc.

• Professional Counselor in Mukwonago, WI
• Providers in Mukwonago, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.