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SAMANTHA DYSON LPC-IT
NPI 1881464568
Counselor - Mental Health in Cedarburg, WI

Active since January 04, 2024PECOS Enrolled
W62N281 WASHINGTON AVE, CEDARBURG, WI 53012(262) 623-7161 Get Directions Write a Review

NPPES record last updated: January 4, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Samantha Dyson Lpc-it NPPES

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

SAMANTHA DYSON LPC-IT (NPI 1881464568) is an individual mental health provider in Cedarburg, Wisconsin, licensed in Wisconsin (7046-226) and active in the NPI registry since January 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1881464568
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameSAMANTHA DYSONCredential: LPC-IT
Location AddressW62N281 WASHINGTON AVECedarburg, WI 53012-2737
Mailing AddressW62n281 Washington AveCedarburg, WI 53012-2737 · (262) 623-7161
Phone(262) 623-7161
Sole ProprietorNo
Enumeration DateJanuary 4, 2024
NPPES CertifiedJanuary 4, 2024
✔ NPI 1881464568 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in WI · 7046-226
W62N281 WASHINGTON AVE, Cedarburg, WI 53012
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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), Group Health Cooperative-SCW and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha Dyson Lpc-it is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Samantha Dyson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kettle Moraine Counseling LLC
14 mi
Mental Health (Including Community Mental Health Center)
400 W RIVER DR
West Bend, WI 53090
  • Reassigned Medicare billing, Wisconsin enrollment
  • 32 clinicians in this Medicare group
NPI 1568790954 (262) 334-4340

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 6

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

ALEXANDER DEMETRIO ANDEREGG LPC-IT, NCC
Counselor (Mental Health)
W62N281 WASHINGTON AVE
CEDARBURG, WI 53012
Ozaukee County (414) 350-6455
MR. ROSS ROBERT BEATTIE MS, LPC
Counselor (Professional)
W62N281 WASHINGTON AVE
CEDARBURG, WI 53012
Ozaukee County (414) 779-7677
MS. ABIGAIL VIRGINIA SCHROEDER LPC-IT
Counselor (Professional)
W62N281 WASHINGTON AVE
CEDARBURG, WI 53012
Ozaukee County (414) 215-0269
KELLY JO KUCK P.T.
Physical Therapist
W62N281 WASHINGTON AVE
CEDARBURG, WI 53012
Ozaukee County (262) 387-1722
SERENA BYE M.S.
Counselor (Professional)
W62N281 WASHINGTON AVE
CEDARBURG, WI 53012
Ozaukee County (262) 334-4340
ALEXANDRA NICOLE PAUL
Counselor (Professional)
W62N281 WASHINGTON AVE
CEDARBURG, WI 53012
Ozaukee County (262) 334-4340

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samantha Dyson's NPI number?

The NPI number for Samantha Dyson is 1881464568. It was assigned to this individual provider in the NPPES registry on January 4, 2024.

Where is Samantha Dyson located?

Samantha Dyson practices at W62n281 Washington Ave, Cedarburg, WI 53012. The listed phone number is (262) 623-7161.

What is Samantha Dyson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Samantha Dyson enrolled in Medicare?

Yes. Samantha Dyson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Samantha Dyson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Dyson reassigns Medicare benefits to Kettle Moraine Counseling LLC (West Bend, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samantha Dyson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Samantha Dyson accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Group Health Cooperative-SCW, HealthPartners and Network Health and 3 other insurers list Samantha Dyson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Samantha Dyson was last updated on January 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.