MR. JACOB M MECCA-GUILLIEN SAC-IT, LPC
NPI 1033687090
Counselor - Professional in Mukwonago, WI

Q: What is Jacob Mecca-guillien's NPI number?

The NPI number for Jacob Mecca-guillien is 1033687090. It was assigned to this individual provider in the NPPES registry on November 8, 2018.

Q: What is Jacob Mecca-guillien's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Active since November 08, 2018PECOS EnrolledAccepts Medicare Assignment

400 BAY VIEW RD STE C, MUKWONAGO, WI 53149(622) 789-1191 Get Directions Write a Review

NPPES record last updated: April 19, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 19, 2022, Nov 8, 2018 (2 updates tracked since 2018).

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About Mr. Jacob M Mecca-guillien Sac-it, Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JACOB M MECCA-GUILLIEN SAC-IT, LPC (NPI 1033687090) is an individual professional provider in Mukwonago, Wisconsin, licensed in Wisconsin (8241-125) and active in the NPI registry since November 2018. He is enrolled in Medicare PECOS, maintains a secondary practice location in West Milwaukee, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1033687090

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameMR. JACOB M MECCA-GUILLIENCredential: SAC-IT, LPC

Location Address400 BAY VIEW RD STE CMukwonago, WI 53149-1770

Mailing Address400 Bay View Rd Ste CMukwonago, WI 53149-1770 · (622) 789-1191

Phone(622) 789-1191

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateNovember 8, 2018

Last NPPES UpdateApril 19, 20222 updates tracked since enumeration

NPPES CertifiedApril 19, 2022

✔ NPI 1033687090 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in WI · 8241-125

Also ListedCounselorTaxonomy 101Y00000X · License 4208-226 (WI)

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 18715-130 (WI)

400 BAY VIEW RD STE C, Mukwonago, WI 53149

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Secondary Practice Location 1

Location 11610 Miller Park WayWest Milwaukee, WI 53214-3604 · Phone (414) 939-7556

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), HealthPartners and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Jacob M Mecca-guillien Sac-it, Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7214374503

PECOS Enrollment IDI20240321004173

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHERINE DIANE COLLINS LCSW 06/13-18

Counselor (Mental Health)