Individual provider Active NPI

Mackenzie Ann Deffenbaugh, LPC

  • Professional Counselor
  • Eau Claire, WI
National Provider Identifier
1871013458
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5094-125 Issued in WI
Practice address
2005 Highland Ave Ste B
Eau Claire, WI 54701-4390
Phone
(715) 832-5454
Fax
(715) 832-2991
NPI assigned
Jun 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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 5094-125 WI Primary

Addresses

Primary practice location

2005 Highland Ave Ste B
Eau Claire, WI 54701-4390

Mailing address

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Phone (651) 628-9566

Other names 1

  • Mackenzie Ann Pichler Former name

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
I20240126001260 WI Practitioner - Mental Health Counselor 2860845724 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Eau ClaireGroup PAC ID 7113350398, 7 clinicians

Practice addresses (Care Compare)

2005 Highland Ave
Suite B
Eau Claire, WI 54701-4390
Phone (866) 559-3060

721 Oxford Ave
Eau Claire, WI 54703-5212
Phone (715) 839-7602

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5094-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates Counseling Wi., S.C. CurrentSince Nov 10, 2025 Accepting new patients
County of Eau Claire CurrentSince Jan 1, 2024 Accepting new patients
Nystrom & Associates Counseling Wi., S.C. CurrentSince Nov 10, 2025 Accepting new patients

Locations

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

2005 Highland Ave
Ste B
Eau Claire, WI 54701
Phone (866) 559-3060

721 Oxford Ave
Eau Claire, WI 54703
Phone (715) 839-2300

201 Main St
Ste 500
La Crosse, WI 54601
Phone (608) 668-4005

Organizations & group practices 3

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": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1871013458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 HIGHLAND AVE STE B",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547014390",
            "telephone_number": "715-832-5454",
            "fax_number": "715-832-2991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFFENBAUGH",
        "first_name": "MACKENZIE",
        "middle_name": "ANN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-23",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5094-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACKENZIE",
            "last_name": "PICHLER",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eau Claire, WI

Sources for this page

Verify at the official NPI Registry.