Individual provider Active NPI

Megan Nicole Smith, MA, LPC

  • Professional Counselor
  • Pewaukee, WI
National Provider Identifier
1699468769
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7170-226 Issued in WI
Practice address
353 Forest Grove Dr Ste 100
Pewaukee, WI 53072-3765
Phone
(262) 745-0405
Fax
(262) 691-2972
NPI assigned
Jun 2, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 7170-226 WI Primary

Addresses

Primary practice location

353 Forest Grove Dr Ste 100
Pewaukee, WI 53072-3765

Mailing address

353 Forest Grove Dr Ste 100
Pewaukee, WI 53072-3765
Phone (262) 745-0405

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
I20250204002519 WI Practitioner - Mental Health Counselor 6901336189 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
7170-226WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Counseling Services, LLC Professional CurrentSince Jan 21, 2025 Accepting new patients

Locations

353 Forest Grove Dr
Ste 100
Pewaukee, WI 53072
Phone (262) 393-1660

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": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1699468769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 FOREST GROVE DR STE 100",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530723765",
            "telephone_number": "262-745-0405",
            "fax_number": "262-691-2972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 FOREST GROVE DR STE 100",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530723765",
            "telephone_number": "262-745-0405",
            "fax_number": "262-691-2972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MEGAN",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-02",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7170-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pewaukee, WI

Sources for this page

Verify at the official NPI Registry.