Metta Vista Mental Health LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

METTA VISTA MENTAL HEALTH LLC

Practice address

10150 W National Ave Ste 204
West Allis, WI 53227-2145

Phone

(414) 617-5143

NPI assigned

Dec 23, 2024

Organization subpart

No

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

Authorized official

Name

Mark Thomas Machak, MS, LPCNPI 1063187383

Title

Owner/LPC

Phone

(414) 617-5143

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark T Machak, LPC

  • Professional Counselor
  • West Allis, WI
  • NPI 1063187383
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1734912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1396553277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3929 E KLIEFORTH AVE",
            "city": "CUDAHY",
            "state": "WI",
            "postal_code": "531103123",
            "telephone_number": "414-617-5143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10150 W NATIONAL AVE STE 204",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272145",
            "telephone_number": "414-617-5143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METTA VISTA MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-23",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A",
        "authorized_official_last_name": "MACHAK",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER/LPC",
        "authorized_official_telephone_number": "414-617-5143",
        "authorized_official_credential": "MS, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in West Allis, WI
• Providers in West Allis, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.