New Depth Counseling & Wellness Services, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

NEW DEPTH COUNSELING & WELLNESS SERVICES, LLC

Practice address

1345 W Mason St Ste 102
Green Bay, WI 54303-2049

Phone

(920) 301-3546

Fax

(920) 301-3400

NPI assigned

Nov 4, 2022

Organization subpart

No

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

Authorized official

Name

Lisa Shaw, LCSWNPI 1629176938

Title

Clinical Social Worker

Phone

(920) 301-3546

Specialties & licenses 1

Addresses

Other names 1

• New Depth Counseling & Wellness Services, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

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.

• Lisa Shaw, MSW, LCSW

  • Clinical Social Worker
  • Green Bay, WI
  • NPI 1629176938
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669161600000",
    "number": "1376250795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N6921 WOODSIDE HILLS DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530831681",
            "telephone_number": "920-980-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 W MASON ST STE 102",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032049",
            "telephone_number": "920-301-3546",
            "fax_number": "920-301-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW DEPTH COUNSELING & WELLNESS SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "920-301-3546",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Depth Counseling & Wellness Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Paul Neustifter, PTA
• Brittany Neveau, APRN
• Elizabeth Grace Neveau, DPT
• Kevin Neveau, DO
• Mallory Neville
• New Dermatology Group LTD
• New Dermatology Group LTD
• New ENT SC
• New Gasmasters LLC
• New Hair, LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; 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.