Individual provider Active NPI

Antoinette Marie Mathis, LPC

  • Professional Counselor
  • La Crosse, WI
National Provider Identifier
1467068924
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
10811-125 Issued in WI
Practice address
115 5TH Ave S Ste 301
La Crosse, WI 54601-4098
Phone
(608) 785-0827
NPI assigned
Sep 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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 10811-125 WI Primary

Addresses

Primary practice location

115 5TH Ave S Ste 301
La Crosse, WI 54601-4098

Mailing address

124 Grayside Ave
Mauston, WI 53948-1913
Phone (608) 847-7575

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
I20240617001483 WI Practitioner - Mental Health Counselor 6103369327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling AssociatesGroup PAC ID 3678622784, 16 clinicians

Practice addresses (Care Compare)

115 5TH Ave S
Suite 301
La Crosse, WI 54601-4098
Phone (608) 785-0827

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Law

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Valley Integrated Services LLC CurrentSince Jan 1, 2024 Accepting new patients
Counseling Associates CurrentSince Apr 2, 2024 Accepting new patients
Brave Spaces Counseling and Wellness, LLC Past Accepting new patients
Pine Valley Residential Services PastSince Sep 27, 2020 Accepting new patients
Counseling Associates PastSince Apr 9, 2024 Accepting new patients

Locations

115 5th Ave S
Ste 301
La Crosse, WI 54601
Phone (608) 785-0827

Organizations & group practices 5

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": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1467068924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 GRAYSIDE AVE",
            "city": "MAUSTON",
            "state": "WI",
            "postal_code": "539481913",
            "telephone_number": "608-847-7575",
            "fax_number": "608-847-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 5TH AVE S STE 301",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014098",
            "telephone_number": "608-785-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "ANTOINETTE",
        "middle_name": "MARIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "10811-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.