TGL Wellness

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

TGL WELLNESS

Practice address

1750 N Calhoun Rd
Brookfield, WI 53005-5037

Phone

(414) 218-6958

NPI assigned

Dec 12, 2019

Last updated

Dec 12, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tyler Loomis, LPCNPI 1770797235

Title

Owner

Phone

(414) 218-6958

Specialties & licenses 1

Addresses

Other names 1

• TGL Wellness Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tyler Loomis, MA, LPC

  • Professional Counselor
  • Brookfield, WI
  • NPI 1770797235
  NPD Authorized official

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576108800000",
    "number": "1083252860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2367 N 46TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532102917",
            "telephone_number": "414-218-6958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 N CALHOUN RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530055037",
            "telephone_number": "414-218-6958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TGL WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-12",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A",
        "authorized_official_last_name": "LOOMIS",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-218-6958",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TGL Wellness",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.