Organization Active NPI

Blue Iris Counseling Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
National Provider Identifier
1578439303
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BLUE IRIS COUNSELING SERVICES LLC
Practice address
1263 Main St Ste 122
Green Bay, WI 54302-1341
Phone
(920) 315-8643
Fax
(920) 214-1274
NPI assigned
Oct 17, 2025
Last updated
Oct 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Authorized official

Name
Megan Meyerhofer, LMFTNPI 1063893667
Title
Owner
Phone
(920) 315-8643

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1263 Main St Ste 122
Green Bay, WI 54302-1341

Mailing address

1263 Main St Ste 122
Green Bay, WI 54302-1341
Phone (920) 315-8643

Other identifiers 1

IdentifierTypeStateIssuer
1063893667MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251204002255 WI Part B Supplier - Clinic/Group Practice 5092208363 Receives reassigned benefits from 1 practitioner
Practice locations: Green Bay, WI

National Provider Directory

National Provider Directory

Locations

1263 Main St
Ste 122
Green Bay, WI 54302
Phone (920) 315-8643

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1760659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760659200000",
    "number": "1578439303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1263 MAIN ST STE 122",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543021341",
            "telephone_number": "920-315-8643",
            "fax_number": "920-214-1274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1263 MAIN ST STE 122",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543021341",
            "telephone_number": "920-315-8643",
            "fax_number": "920-214-1274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE IRIS COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-17",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A",
        "authorized_official_last_name": "MEYERHOFER",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-315-8643",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063893667",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; 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.