KATIE NICOLE WIECZOREK LPC-MH, QMHP
NPI 1184349839
Counselor in Mitchell, SD

Active since October 05, 2022PECOS EnrolledAccepts Medicare Assignment
712 S SANBORN BLVD STE 9, MITCHELL, SD 57301(605) 674-3797 Get Directions Write a Review

NPPES record last updated: February 10, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 30, 2026, Oct 5, 2022 (2 updates tracked since 2022).

About Katie Nicole Wieczorek Lpc-mh, Qmhp NPPES

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

KATIE NICOLE WIECZOREK LPC-MH, QMHP (NPI 1184349839) is an individual counselor in Mitchell, South Dakota, licensed in South Dakota (30826) and active in the NPI registry since October 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1184349839
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameKATIE NICOLE WIECZOREKCredential: LPC-MH, QMHP
Location Address712 S SANBORN BLVD STE 9Mitchell, SD 57301-3902
Mailing Address712 S Sanborn Blvd, Ste 9 Pmb#6143Mitchell, SD 57301-3902 · (605) 674-3797
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateOctober 5, 2022
Last NPPES UpdateFebruary 10, 20262 updates tracked since enumeration
NPPES CertifiedFebruary 10, 2026
NPI 1184349839 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License Licensed in SD · 30826
Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License QMHP (SD)
712 S SANBORN BLVD STE 9, Mitchell, SD 57301

Other Identifiers 3

Other30826SD · Lpc-mh
OtherQMHPSD · State Qmhp Certificate
Other20535SD · State License - Lpc

Accepted 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

Katie Nicole Wieczorek Lpc-mh, Qmhp 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 ID3375027147
PECOS Enrollment IDI20260319001597
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.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1184349839, enumerated as an "individual" on October 05, 2022.

The provider is located at 712 S SANBORN BLVD STE 9 MITCHELL, SD 57301 and the phone number is (605) 674-3797.

Counselor with taxonomy code 101Y00000X.

The provider might be accepting Accepts: Avera Health Plans, Sanford Health Plan, Medicare. Please consult your insurance carrier or call the provider to verify.