Wisdom Within Wellness LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

WISDOM WITHIN WELLNESS LLC

Doing business as

Kellyjoy Kanaley, LPC

Practice address

1235 SE Division St Ste 205
Portland, OR 97202-1000

Phone

(503) 473-2910

Fax

(844) 440-2129

NPI assigned

Nov 30, 2023

Last updated

Dec 4, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kellyjoy Kanaley, LPCNPI 1083977854

Title

Member Manager/President

Phone

(503) 473-2910

Specialties & licenses 1

Addresses

Other names 1

• Kellyjoy Kanaley, LPC Doing business as

Locations

Practitioners 1

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.

• Kellyjoy Kanaley, LPC

  • Mental Health Counselor
  • Portland, OR
  • NPI 1083977854
  NPD Authorized official

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

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1437925427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 SE 62ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972063605",
            "telephone_number": "503-473-2910",
            "fax_number": "844-440-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 SE DIVISION ST STE 205",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021000",
            "telephone_number": "503-473-2910",
            "fax_number": "844-440-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISDOM WITHIN WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A",
        "authorized_official_last_name": "KANALEY",
        "authorized_official_first_name": "KELLYJOY",
        "authorized_official_title_or_position": "MEMBER MANAGER/PRESIDENT",
        "authorized_official_telephone_number": "503-473-2910",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kellyjoy Kanaley, LPC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stacy Lynn Wirth, M.A. L.P.C.
• Molz Wirtz-Wold, LMHC, LPC
• Amy Lynn Wirtz, LCSW
• Erin Wirtz, LCSW
• Wisdom Way Medicine, LLC
• Anna Wisdom
• Jennifer Wisdom
• Joseph Aaron Wisdom, DC
• Wise Blood Healing LLC
• Wise Chiropractic, LLC

• Adult Mental Health Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Adult Mental Health Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.