Integrated Life Counseling Center, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7824-123 Issued in WI

Legal business name

INTEGRATED LIFE COUNSELING CENTER, LLC

Practice address

215 N Main St
205
West Bend, WI 53095-3347

Phone

(262) 416-2922

NPI assigned

Mar 9, 2016

Organization subpart

No

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

Authorized official

Name

Hadwat Sankari, LCSWNPI 1467611673

Title

Social Worker, LCSW

Phone

(262) 416-2922

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

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

• Hadwat A. Sankari, LCSW

  • Clinical Social Worker
  • West Bend, WI
  • NPI 1467611673
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1457481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457481600000",
    "number": "1518328277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 TERRACE DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530954748",
            "telephone_number": "262-416-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N MAIN ST",
            "address_2": "205",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530953347",
            "telephone_number": "262-416-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED LIFE COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-09",
        "last_updated": "2016-03-09",
        "status": "A",
        "authorized_official_last_name": "SANKARI",
        "authorized_official_first_name": "HADWAT",
        "authorized_official_title_or_position": "SOCIAL WORKER, LCSW",
        "authorized_official_telephone_number": "262-416-2922",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7824-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Jill Hussussian
• Courtney Ann Immel, RD, CD
• Independent Physicians of Wisconsin LLC
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• Inner Peace Counseling and Wellness LLC
• International Quality Homecare Corp
• International Quality Homecare of Wisconsin LLC
• Shannon Jacklin, APNP
• Zachery Lazar Jacober, D.C.
• Bonnie Lee Jacobs, MSW LCSW

• Clinical Social Worker in West Bend, WI
• Providers in West Bend, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.