Physiological Health Sanctuary LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PHYSIOLOGICAL HEALTH SANCTUARY LLC

Practice address

500 W Silver Spring Dr Ste K200
Glendale, WI 53217-5052

Phone

(414) 207-4415

NPI assigned

Oct 13, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Alexander Yundt, MSNPI 1982141883

Title

LPC

Phone

(414) 350-7286

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alexander Yundt, LPC

  • Mental Health Counselor
  • Glendale, WI
  • NPI 1982141883
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711584000000",
    "number": "1003414970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W SILVER SPRING DR STE K200",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532175052",
            "telephone_number": "414-207-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W SILVER SPRING DR STE K200",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532175052",
            "telephone_number": "414-207-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIOLOGICAL HEALTH SANCTUARY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-13",
        "last_updated": "2024-03-28",
        "certification_date": "2022-11-14",
        "status": "A",
        "authorized_official_last_name": "YUNDT",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "LPC",
        "authorized_official_telephone_number": "414-350-7286",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Glendale, WI
• Providers in Glendale, WI by specialty
• Community/Behavioral Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.