NPIMap

Organization Active NPI

Holistic Wellness Center LLC

  • Group Psychotherapy Psychologist
  • Brookfield, WI
National Provider Identifier
1285726661
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Group Psychotherapy PsychologistTaxonomy code 103TP2701X
License
2524 Issued in WI
Legal business name
HOLISTIC WELLNESS CENTER LLC
Practice address
675 N Brookfield Rd
Suite 101
Brookfield, WI 53045-5858
Phone
(262) 641-9300
Fax
(262) 641-9307
NPI assigned
Sep 29, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jeff Scott Hollowell, PH.D.
Title
Psychologist/Owner
Phone
(262) 641-9300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Group Psychotherapy Psychologist 103TP2701X 2524 WI Primary

Addresses

Primary practice location

675 N Brookfield Rd
Suite 101
Brookfield, WI 53045-5858

Mailing address

675 N Brookfield Rd
Suite 101
Brookfield, WI 53045-5858
Phone (262) 641-9300

Other identifiers 1

IdentifierTypeStateIssuer
42235800MedicaidWI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285726661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 N BROOKFIELD RD",
            "address_2": "SUITE 101",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455858",
            "telephone_number": "262-641-9300",
            "fax_number": "262-641-9307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N BROOKFIELD RD",
            "address_2": "SUITE 101",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455858",
            "telephone_number": "262-641-9300",
            "fax_number": "262-641-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLLOWELL",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "262-641-9300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "WI",
            "license": "2524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42235800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.