Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mathew Avery Mayes, LPC-IT, SAC-IT

Individual provider Counselor · NPI 1255015962

Mathew Avery Mayes, LPC-IT, SAC-IT is a Mental Health Counselor in West Allis, Wisconsin. Qualified in 2022, 4 years ago. Licensed in Wisconsin.

Years since qualifying
4
Licensed in
WI
In the registry since
2023
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Practice location Address checks out

1205 S 70th St Ste 301 1205
West Allis, WI 53214-3167
Phone: (414) 531-5207
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X · Licence 7265-226 (WI)

Record details

NPI number1255015962
Entity typeIndividual (Type 1)
GenderMale
Credentials LPC-IT , SAC-IT
Sole proprietorNo
NPI enumeratedJune 13, 2023
Last updated in NPPESJune 13, 2023
Certification dateJune 13, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in West Allis