Organization Active NPI

Wellness Institute LLC

  • Professional Counselor
  • Lake Ozark, MO
National Provider Identifier
1124632492
Registry record updated Jun 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
WELLNESS INSTITUTE LLC
Practice address
752 Bagnell Dam Blvd Ste B
Lake Ozark, MO 65049-8716
Phone
(573) 693-1119
Fax
(573) 557-4163
NPI assigned
Sep 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2026

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

Authorized official

Name
Mrs. Cibele F C Elliott, MED. / LPC/ EMDRNPI 1053750869
Title
Clinical Therapist
Phone
(573) 480-3501

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

752 Bagnell Dam Blvd Ste B
Lake Ozark, MO 65049-8716

Mailing address

752 Bagnell Dam Blvd Ste B
Lake Ozark, MO 65049-8716
Phone (573) 693-1119

Other identifiers 1

IdentifierTypeStateIssuer
1111582MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240301001764 MO Part B Supplier - Clinic/Group Practice 1153766050 Receives reassigned benefits from 2 practitioners
Practice locations: Lake Ozark, MO

National Provider Directory

National Provider Directory

Locations

752 Bagnell Dam Blvd
Ste B
Lake Ozark, MO 65049
Phone (573) 693-1119

Practitioners & affiliated clinicians

Practitioners 2

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": "1599091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781827200000",
    "number": "1124632492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 BAGNELL DAM BLVD STE B",
            "city": "LAKE OZARK",
            "state": "MO",
            "postal_code": "650498716",
            "telephone_number": "573-693-1119",
            "fax_number": "573-557-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "752 BAGNELL DAM BLVD STE B",
            "city": "LAKE OZARK",
            "state": "MO",
            "postal_code": "650498716",
            "telephone_number": "573-693-1119",
            "fax_number": "573-557-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-03",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "CIBELE",
        "authorized_official_middle_name": "F C",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "573-480-3501",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MED. / LPC/ EMDR"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1111582",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Ozark, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.