Organization Active NPI

Intentional Wellness Therapy, LLC

  • Mental Health Counselor
  • La Porte, IN
National Provider Identifier
1356255707
Registry record updated Oct 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
INTENTIONAL WELLNESS THERAPY, LLC
Practice address
1905 Indiana Ave
La Porte, IN 46350-6005
Phone
(574) 387-0358
NPI assigned
Oct 1, 2026
Last updated
Oct 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2026

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

Authorized official

Name
Stephanie L Metcalf
Title
Owner
Phone
(574) 387-0358

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1905 Indiana Ave
La Porte, IN 46350-6005

Mailing address

1905 Indiana Ave
La Porte, IN 46350-6005
Phone (574) 387-0358

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1790812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790812800000",
    "number": "1356255707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 INDIANA AVE",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463506005",
            "telephone_number": "574-387-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 INDIANA AVE",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463506005",
            "telephone_number": "574-387-0358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTENTIONAL WELLNESS THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-01",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A",
        "authorized_official_last_name": "METCALF",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-387-0358"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Porte, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; 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.