NPIMap

Organization Active NPI

Living Well Christian Family Clinic, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
National Provider Identifier
1447428719
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LIVING WELL CHRISTIAN FAMILY CLINIC, LLC
Practice address
575 Lester Ave Ste 100
Onalaska, WI 54650-8695
Phone
(608) 783-1452
NPI assigned
Feb 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Authorized official

Name
Kami Jo Lipps, MSNPI 1306026067
Title
Owner
Phone
(608) 783-1452

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

575 Lester Ave Ste 100
Onalaska, WI 54650-8695

Mailing address

575 Lester Ave Ste 100
Onalaska, WI 54650-8695
Phone (608) 783-1452

Other identifiers 1

IdentifierTypeStateIssuer
42253100MedicaidWI

National Provider Directory

National Provider Directory

Locations

575 Lester Ave
Ste 100
Onalaska, WI 54650
Phone (608) 781-5301

1288 Rudy St
Ste 108
Onalaska, WI 54650

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602028800000",
    "number": "1447428719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 LESTER AVE STE 100",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546508695",
            "telephone_number": "608-783-1452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 LESTER AVE STE 100",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546508695",
            "telephone_number": "608-783-1452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL CHRISTIAN FAMILY CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "LIPPS",
        "authorized_official_first_name": "KAMI",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-783-1452",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42253100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Onalaska, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.