Integrated Wellness Management Inc

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

INTEGRATED WELLNESS MANAGEMENT INC

Practice address

50 Lake Ave
Worcester, MA 01604-1168

Phone

(508) 361-3735

NPI assigned

Jun 1, 2016

Organization subpart

No

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

Authorized official

Name

Nathan Peterson, LMHC

Title

Authorized Official

Phone

(508) 361-3735

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 1

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

• Brenda Gail Wise, LPC

  • Counselor
  • Shermans Dale, PA
  • NPI 1558994483
  Medicare reassignment NPD

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467072000000",
    "number": "1508214545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LAKE AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016041168",
            "telephone_number": "508-361-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 LAKE AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016041168",
            "telephone_number": "508-361-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED WELLNESS MANAGEMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-01",
        "last_updated": "2016-06-28",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "508-361-3735",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Instant Transportation, LLC
• Institute for Trauma and Healing
• Integral Health Partners LLC
• Integral Primary Care Practice PLLC
• Integrated Dermatology of Worcester II LLC
• Internal Medicine and Endocrinology, Inc.
• Melissa Iodice
• Carolina Ionete, MD
• Lisa Iorio, NP
• Michelle Serena Iorio

• Mental Health Counselor in Worcester, MA
• Providers in Worcester, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; 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.