Individual provider Active NPI

Sergio Guerrero, LPC

  • Mental Health Counselor
  • Menasha, WI
National Provider Identifier
1053064097
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10670-125 Issued in WI
Practice address
1205 Province Ter
Menasha, WI 54952-7017
Phone
(920) 886-9319
NPI assigned
Jan 31, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10670-125 WI Primary

Addresses

Primary practice location

1205 Province Ter
Menasha, WI 54952-7017

Mailing address

1205 Province Ter
Menasha, WI 54952-7017
Phone (920) 886-9319

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240110001833 WI Practitioner - Mental Health Counselor 7315398781 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Samaritan Counseling Center of the Fox Valley, Inc.Group PAC ID 9234034349, 11 clinicians
Partnership Community Health Center IncGroup PAC ID 2062452600, 9 clinicians

Practice addresses (Care Compare)

110 Church Ave
Oshkosh, WI 54901-4746
Phone 9208869319118

1205 Province Ter
Menasha, WI 54952-7017
Phone 9208869319118

5337 W Grande Market Dr
Appleton, WI 54913-8442
Phone (920) 731-7445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10670-125WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Counseling Center of the Fox Valley, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Partnership Community Health Center, Inc Past Accepting new patients

Locations

1478 Kenwood Dr
Ste 1
Menasha, WI 54952
Phone (920) 886-9319

709 W Pine St
New London, WI 54961

110 Church Ave
Oshkosh, WI 54901
Phone (920) 235-1678

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1053064097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 PROVINCE TER",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549527017",
            "telephone_number": "920-886-9319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 PROVINCE TER",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549527017",
            "telephone_number": "920-886-9319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRERO",
        "first_name": "SERGIO",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-31",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "10670-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menasha, WI

Sources for this page

Verify at the official NPI Registry.