Individual provider Active NPI

Justin Mistretta, LPC

  • Professional Counselor
  • Madison, WI
National Provider Identifier
1346858792
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7849 Issued in WI
Practice address
7617 Mineral Point Rd Ste 300
Madison, WI 53717-1623
Phone
(608) 833-9290
Fax
(608) 833-9691
NPI assigned
Jul 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 7849 WI Primary

Addresses

Primary practice location

7617 Mineral Point Rd Ste 300
Madison, WI 53717-1623

Mailing address

7617 Mineral Point Rd Ste 300
Madison, WI 53717-1623
Phone (608) 833-9290

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
I20240325000197 WI Practitioner - Mental Health Counselor 1355788563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Psychology Center S CGroup PAC ID 6507857463, 27 clinicians

Practice addresses (Care Compare)

7617 Mineral Point Rd
Suite 300
Madison, WI 53717-1623
Phone (608) 833-9290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Psychology Center S C CurrentSince Jan 1, 2024 Accepting new patients

Locations

7617 Mineral Point Rd
Madison, WI 53717
Phone (608) 833-9290

7617 Mineral Point Rd
Ste 300
Madison, WI 53717
Phone (608) 833-9290

Organizations & group practices 1

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": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1346858792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7617 MINERAL POINT RD STE 300",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171623",
            "telephone_number": "608-833-9290",
            "fax_number": "608-833-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7617 MINERAL POINT RD STE 300",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171623",
            "telephone_number": "608-833-9290",
            "fax_number": "608-833-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISTRETTA",
        "first_name": "JUSTIN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-21",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.