Individual provider Active NPI

Phyllis Mogielski Watson, LPCC

  • Mental Health Counselor
  • Beavercreek, OH
National Provider Identifier
1295909851
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180001282 Issued in IL
Practice address
70 Birch Aly
Beavercreek, OH 45440-1479
Phone
(800) 892-2695
NPI assigned
Apr 15, 2008
Last updated
Dec 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X E.2303621 OH
Mental Health Counselor 101YM0800X 46.006844 CT
Mental Health Counselor 101YM0800X CC7537 ME
Mental Health Counselor 101YM0800X 288691 KY
Mental Health Counselor 101YM0800X LPC.0018030 CO
Mental Health Counselor 101YM0800X 2999 WV
Mental Health Counselor 101YM0800X 0011569 DE
Mental Health Counselor 101YM0800X LPC.20988 AZ
Mental Health Counselor 101YM0800X 180001282 IL Primary
Professional Counselor 101YP2500X E.2303621 OH
Professional Counselor 101YP2500X 180001282 IL

Addresses

Primary practice location

70 Birch Aly
Beavercreek, OH 45440-1479

Mailing address

101 Centerpoint Dr Ste 105
Middletown, CT 06457-7568
Phone (866) 744-1930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, OH, DE, ME, CO, IL, WV, NH, KY9 enrollments
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 9

Enrollment IDStateProvider typePAC IDDetails
I20240102003107 CT Practitioner - Mental Health Counselor 7315397403 Reassigns benefits to 3 organizations
I20240207002112 OH Practitioner - Mental Health Counselor 7315397403 Reassigns benefits to 3 organizations
I20240306000264 DE Practitioner - Mental Health Counselor 7315397403 Reassigns benefits to 2 organizations
I20240911000171 ME Practitioner - Mental Health Counselor 7315397403 Reassigns benefits to 1 organization
I20241002002792 CO Practitioner - Mental Health Counselor 7315397403 Reassigns benefits to 1 organization
I20241007000662 IL Practitioner - Mental Health Counselor 7315397403 Reassigns benefits to 1 organization
I20241023004927 WV Practitioner - Mental Health Counselor 7315397403 Reassigns benefits to 2 organizations
I20241025002983 NH Practitioner - Mental Health Counselor 7315397403 Reassigns benefits to 2 organizations
I20241204001914 KY Practitioner - Mental Health Counselor 7315397403 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC.20988AZMDMental Health Counselor
46.006844CTMDMental Health Counselor
0011569DEMDMental Health Counselor
288691KYMDMental Health Counselor
2999WVMDMental Health Counselor
180001282ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pursuecare Connecticut PC Professional CurrentSince Jan 1, 2024 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Aug 23, 2024 Accepting new patients
Pursuecare NH LLC Mental Health CurrentSince Oct 16, 2024 Accepting new patients
Cloud Health Medical Group, P.a. CurrentSince Oct 16, 2024 Accepting new patients
Pai CT PLLC Professional CurrentSince Sep 16, 2024 Accepting new patients
Pursuecare, LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Pai Medical WV PLLC Professional CurrentSince Oct 10, 2024 Accepting new patients

Locations

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

250 Fillmore St
Unit 150
Denver, CO 80206
Phone (410) 505-0521

5445 Dtc Pkwy
Ph 4
Greenwood Village, CO 80111
Phone (720) 571-4874

100 Pearl St
Fl 14
Hartford, CT 06103
Phone (860) 421-6636

101 Centerpoint Dr
Ste 105
Middletown, CT 06457
Phone (860) 245-8553

200 Continental Dr
Ste 401
Newark, DE 19713
Phone (302) 238-6200

4735 Ogletown Stanton Rd
Ste 2112
Newark, DE 19713
Phone (302) 623-2853

1209 N Orange St
Wilmington, DE 19801
Phone (800) 875-1575

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338

306 W Main St
Ste 512
Frankfort, KY 40601
Phone (860) 215-2295

312 S 4th St
Ste 700
Louisville, KY 40202
Phone (502) 628-5023

4010 DuPont Cir
Ste 449
Louisville, KY 40207
Phone (860) 270-0485

128 State St
Ste 3
Augusta, ME 04330
Phone (860) 270-0485

254 Commercial St
Ste 245
Portland, ME 04101
Phone (207) 716-5309

3 Executive Park Dr
#201A
Bedford, NH 03110
Phone (860) 245-8553

4400 Easton Cmns
Ste 125
Columbus, OH 43219
Phone (855) 679-2366

1308 4th Ave
Huntington, WV 25701
Phone (304) 525-1222

3058C Charles Town Rd
Kearneysville, WV 25430
Phone (860) 270-0485

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1295909851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CENTERPOINT DR STE 105",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064577568",
            "telephone_number": "866-744-1930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 BIRCH ALY",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454401479",
            "telephone_number": "800-892-2695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGIELSKI WATSON",
        "first_name": "PHYLLIS",
        "name_prefix": "Dr.",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-15",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2303621",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "46.006844",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "CC7537",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "288691",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0018030",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WV",
            "license": "2999",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "DE",
            "license": "0011569",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC.20988",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180001282",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2303621",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180001282",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.