NPIMap

Organization Active NPI

Heal From Within

  • Clinical Social Worker
  • Bristol, WI
National Provider Identifier
1033849062
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
HEAL FROM WITHIN
Practice address
6401 205TH Ave
Bristol, WI 53104-9730
Phone
(847) 774-2264
NPI assigned
Jun 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Authorized official

Name
Jessica Rummel Busch, LCSW
Title
Owner
Phone
(847) 774-2264

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

6401 205TH Ave
Bristol, WI 53104-9730

Mailing address

6401 205TH Ave
Bristol, WI 53104-9730
Phone (847) 774-2264

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1033849062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 205TH AVE",
            "city": "BRISTOL",
            "state": "WI",
            "postal_code": "531049730",
            "telephone_number": "847-774-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 205TH AVE",
            "city": "BRISTOL",
            "state": "WI",
            "postal_code": "531049730",
            "telephone_number": "847-774-2264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAL FROM WITHIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "BUSCH",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "RUMMEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-774-2264",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.