Integrate Wellness Center LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

INTEGRATE WELLNESS CENTER LLC

Doing business as

Integrate Wellness Counseling LLC

Practice address

120 Aliso Dr SE
Albuquerque, NM 87108-2693

Phone

(505) 600-2314

Fax

(866) 635-1177

NPI assigned

May 1, 2023

Organization subpart

No

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

Authorized official

Name

Elizabeth Diesel, LCSWNPI 1659770246

Title

Psychotherapist

Phone

(505) 600-2314

Specialties & licenses 1

Addresses

Other names 1

• Integrate Wellness Counseling LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elizabeth Diesel, LMSW

  • Clinical Social Worker
  • Albuquerque, NM
  • NPI 1659770246
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1376232934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36072",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871766072",
            "telephone_number": "505-600-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 ALISO DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082693",
            "telephone_number": "505-600-2314",
            "fax_number": "866-635-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATE WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-01",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "DIESEL",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "505-600-2314",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integrate Wellness Counseling LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Social Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.