Rewilding Wellness LLC

Primary specialty

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

Legal business name

REWILDING WELLNESS LLC

Practice address

455 State Rd # 397
Vineyard Haven, MA 02568-5695

Phone

(508) 444-9229

NPI assigned

Aug 26, 2022

Organization subpart

No

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

Authorized official

Name

Gabrielle Chudnow, LMHCNPI 1669097325

Title

Founder

Phone

(508) 444-9229

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Gabrielle Chudnow, MA

  • Mental Health Counselor
  • Vineyard Haven, MA
  • NPI 1669097325
  NPD Authorized official

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661472000000",
    "number": "1447979828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 STATE RD # 397",
            "city": "VINEYARD HAVEN",
            "state": "MA",
            "postal_code": "025685695",
            "telephone_number": "508-444-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 STATE RD # 397",
            "city": "VINEYARD HAVEN",
            "state": "MA",
            "postal_code": "025685695",
            "telephone_number": "508-444-9229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REWILDING WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-26",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A",
        "authorized_official_last_name": "CHUDNOW",
        "authorized_official_first_name": "GABRIELLE",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "508-444-9229",
        "authorized_official_credential": "LMHC"
    },
    "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": []
}

• Katherine Federowicz Perez
• Jason Peringer, ATC, CSCS, LMT
• Jill Placzek
• Siren A Polat, LMHC, MFT
• Retina Care Massachusetts PLLC
• Joan Ella Rice
• Richard John McNulty D.M.D. LLC
• Elizabeth Renee Ricketts
• Jessica Roberto, LCSW
• Cynthia Ann Robinson, M.A.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Vineyard Haven, MA
• Providers in Vineyard Haven, MA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; 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.