MATTHEW JOHNSON LPC, SAC-IT
NPI 1396523437
Counselor - Professional in West Bend, WI

Q: What is Matthew Johnson's NPI number?

The NPI number for Matthew Johnson is 1396523437. It was assigned to this individual provider in the NPPES registry on September 19, 2023.

Q: What is Matthew Johnson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Matthew Johnson was last updated on June 26, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 19, 2023PECOS Enrolled

1622 CHESTNUT ST, WEST BEND, WI 53095(262) 306-9800 Get Directions Write a Review

NPPES record last updated: June 26, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Matthew Johnson Lpc, Sac-it NPPES

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

MATTHEW JOHNSON LPC, SAC-IT (NPI 1396523437) is an individual professional provider in West Bend, Wisconsin, licensed in Wisconsin (11882-125) and active in the NPI registry since September 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1396523437

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameMATTHEW JOHNSONCredential: LPC, SAC-IT

Location Address1622 CHESTNUT STWest Bend, WI 53095-3014

Mailing AddressW168n9096 Garden AveMenomonee Falls, WI 53051-2114

Phone(262) 306-9800

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateSeptember 19, 2023

Last NPPES UpdateJune 26, 2025

NPPES CertifiedJune 26, 2025

✔ NPI 1396523437 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 · 11882-125

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 20000-130 (WI)

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 7352-226 (WI)

1622 CHESTNUT ST, West Bend, WI 53095

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Matthew Johnson Lpc, Sac-it is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7416461140

PECOS Enrollment IDI20250707001541

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 20

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

KATHERINE SUE LIAROMATIS SAC-IT 17948-130

Clinic/Center (Mental Health (Including Community Mental Health Center))