NPIMap

Organization Active NPI

Foundations Health and Wholeness Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
National Provider Identifier
1497840607
Registry record updated May 14, 2026
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
FOUNDATIONS HEALTH AND WHOLENESS INC
Practice address
Foundations Health and Wholeness Inc
1061 W Mason St.
Green Bay, WI 54303-1858
Phone
(920) 437-8256
Fax
(920) 437-1188
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Authorized official

Name
Roxanne Leigh Tisch
Title
Director of Finance
Phone
(920) 265-2305

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X 1035 WI
Clinical Child & Adolescent PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC2200X 1035 WI
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X 1035 WI
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

Foundations Health and Wholeness Inc
1061 W Mason St.
Green Bay, WI 54303-1858

Mailing address

1061 W Mason St
Green Bay, WI 54303-1858
Phone (920) 437-8256

Other identifiers 1

IdentifierTypeStateIssuer
42180100MedicaidWI

Other names 1

  • American Foundation of Counseling Services Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040210001024 WI Part B Supplier - Clinic/Group Practice 5597659631 Receives reassigned benefits from 11 practitioners
Practice locations: Green Bay, WI

National Provider Directory

National Provider Directory

Locations

130 E Walnut St
Ste 706
Green Bay, WI 54301
Phone (920) 437-8256

Practitioners & affiliated clinicians

Practitioners 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778716800000",
    "number": "1497840607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 W MASON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543031858",
            "telephone_number": "920-437-8256",
            "fax_number": "920-437-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FOUNDATIONS HEALTH AND WHOLENESS INC",
            "address_2": "1061 W MASON ST.",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543031858",
            "telephone_number": "920-437-8256",
            "fax_number": "920-437-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATIONS HEALTH AND WHOLENESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A",
        "authorized_official_last_name": "TISCH",
        "authorized_official_first_name": "ROXANNE",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "920-265-2305"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "1035",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "WI",
            "license": "1035",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "1035",
            "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": "42180100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Foundation of Counseling Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; 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.