Individual provider Active NPI

Jonah Mical Anderson, LPC, MA, CSAT

  • Professional Counselor
  • Hartland, WI
National Provider Identifier
1972081347
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8529 Issued in WI
Practice address
300 Cottonwood Ave Ste 8
Hartland, WI 53029-2043
Phone
(262) 302-0016
NPI assigned
Jul 29, 2018
Last updated
Sep 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 559767 WI
Mental Health Counselor 101YM0800X 559767 WI
Professional Counselor 101YP2500X 8529 WI Primary

Addresses

Primary practice location

300 Cottonwood Ave Ste 8
Hartland, WI 53029-2043

Mailing address

11632 W Bluemound Rd
Wauwatosa, WI 53226-3937
Phone (262) 302-0016

Other practice location 1

5508 W Vliet St
Milwaukee, WI 53208-2120
Phone (414) 476-1073

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
I20240530000686 WI Practitioner - Mental Health Counselor 0648612051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cornerstone Counseling Services IncGroup PAC ID 1456256023, 338 clinicians

Practice addresses (Care Compare)

11649 N Port Washington Rd
Suite 221
Mequon, WI 53092-3461
Phone (262) 999-3495

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
559767WIMDAddiction (Substance Use Disorder) Counselor
8529WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Counseling Services, Inc Addiction (Substance Use Disorder) CurrentSince Apr 16, 2024 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

16535 W Bluemound Rd
Ste 200
Brookfield, WI 53005
Phone (262) 789-0909

11518 N Port Washington Rd
Ste 202
Mequon, WI 53092
Phone (262) 244-6177

11649 N Port Washington Rd
Ste 221
Mequon, WI 53092
Phone (262) 912-1922

1143 Warwick Way
Racine, WI 53406
Phone (262) 321-0110

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, 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": "1532822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1972081347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11632 W BLUEMOUND RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263937",
            "telephone_number": "262-302-0016",
            "fax_number": "608-509-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COTTONWOOD AVE STE 8",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "530292043",
            "telephone_number": "262-302-0016"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5508 W Vliet St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532082120",
            "country_code": "US",
            "telephone_number": "414-476-1073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JONAH",
        "middle_name": "MICAL",
        "credential": "LPC, MA, CSAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-29",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "559767",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "559767",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "8529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartland, WI

Sources for this page

Verify at the official NPI Registry.