Authentic Wellness, LLC
Organization Active NPI Professional Counselor · Hancock, MI
NPI 1396484366 · NPPES record last updated Aug 6, 2023
Key facts
- NPI
- 1396484366
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Professional Counselor 101YP2500X
- Legal business name
- AUTHENTIC WELLNESS, LLC
- Practice address
- 54354 State Highway M203
Hancock, MI 49930-9448 - Phone
- (906) 281-4806
- NPI assigned
- May 30, 2022
- Organization subpart
- No
Authorized official
- Name
- Kelly Niileksela
- Title
- Co-Owner
- Phone
- (906) 299-9355
Practitioners 3
-
Zoe Michelle Lincoln, LPC
-
Kelly Niileksela, LMT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231101001637 | MI | Part B Supplier - Clinic/Group Practice | 9931555612 |
Receives reassigned benefits from 1 practitioner Practice locations: Hancock, MI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor |
101YP2500X | Yes | ||
| Clinical Social Worker |
1041C0700X |
Addresses
Primary practice location
54354 State Highway M203
Hancock, MI 49930-9448
Mailing address
54354 State Highway M203
Hancock, MI 49930-9448
Phone (906) 281-4806
Other providers in Hancock, MI
- Aspirus Superior Home Health and Hospice Inc
- Aspirus Superior Home Health and Hospice Inc
- Aspirus Vna Home Health Inc.
- Aspirus Vna Home Health, Inc.
- Atlas Radiology PC
- Cathy Fakler Azzarello
- Kristen Louise Babakitis
- Amy Bachhuber
- Ashley Bakewell
- Jocelyn Barney
All providers in Hancock, MI · Professional Counselor in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.