Embodied-Welllbeing

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

EMBODIED-WELLLBEING

Practice address

2501 Jenny Lane
Green Bay, WI 54302

Phone

(920) 212-7523

NPI assigned

Dec 22, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Keith Paul Neilitz, LPC

Title

Clinical Therapist

Phone

(920) 521-8940

Specialties & licenses 1

Addresses

Tax ID family

Embodied-Wellbeing Limited Liability Company2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Embodied-Wellbeing Limited Liability Company

  • Professional Counselor
  • Green Bay, WI
  • NPI 1851003826
  NPD tax ID

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

{
    "created_epoch": "1671667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698969600000",
    "number": "1124730023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 JENNY LN APT 8",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543025039",
            "telephone_number": "920-521-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 JENNY LANE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54302",
            "telephone_number": "920-212-7523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBODIED-WELLLBEING",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-22",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A",
        "authorized_official_last_name": "NEILITZ",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "920-521-8940",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Elm
• Tariq Elmadawy
• Unknown Elsa Kurian, DDS
• Muna Elsiddig, MD
• Embodied-Wellbeing Limited Liability Company
• Tucker Anthony Emerson, D.C.
• Kate Henniges Emme, SLP
• Ethan Errol Emmons, MD
• Lydia R Emnott, PA-C
• Emplify Health Behavioral Health (Bellin Memorial Hospital Inc)

• Professional Counselor in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.