Individual provider Active NPI

Manuel Cerda, LPC-IT, SAC-IT

  • Mental Health Counselor
  • Madison, WI
National Provider Identifier
1730802976
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2701 International LN Ste 201
Madison, WI 53704-3126
Phone
(608) 719-0170
Fax
(608) 709-1744
NPI assigned
Sep 22, 2022
Last updated
Feb 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 20391 WI
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

2701 International LN Ste 201
Madison, WI 53704-3126

Mailing address

815 Forward Dr
Madison, WI 53711
Phone (608) 268-6530

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
I20260427002813 WI Practitioner - Mental Health Counselor 1052888005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

815 Forward Dr
Madison, WI 53711-2443

92 Tulip Ave
Belgrade, MT 59714-7540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20391WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesis Center for Marriage and Family Therapy Addiction (Substance Use Disorder) CurrentSince Sep 1, 2024 Accepting new patients
Anesis Foundation for Mental Health Inc. CurrentSince Feb 24, 2026 Accepting new patients

Locations

2701 International Ln
Ste 201
Madison, WI 53704
Phone (608) 268-6530

815 Forward Dr
Madison, WI 53711
Phone (608) 268-6530

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1730802976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 FORWARD DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53711",
            "telephone_number": "608-268-6530",
            "fax_number": "608-709-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 INTERNATIONAL LN STE 201",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537043126",
            "telephone_number": "608-719-0170",
            "fax_number": "608-709-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERDA",
        "first_name": "MANUEL",
        "credential": "LPC-IT, SAC-IT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-22",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "20391",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.