NPIMap

Organization Active NPI

Nourishing Change

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Menasha, WI
National Provider Identifier
1588575245
Registry record updated Sep 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
NOURISHING CHANGE
Practice address
1476 Kenwood Dr Ste 102
Menasha, WI 54952-1134
Phone
(920) 939-8868
Fax
(920) 939-7042
NPI assigned
Sep 14, 2026
Last updated
Sep 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Authorized official

Name
Amy Megan Taake, LPC, SACNPI 1194234922
Title
Owner/ Therapist
Phone
(920) 939-8868

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1476 Kenwood Dr Ste 102
Menasha, WI 54952-1134

Mailing address

1476 Kenwood Dr Ste 102
Menasha, WI 54952-1134
Phone (920) 939-8868

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1789344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789344000000",
    "number": "1588575245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1476 KENWOOD DR STE 102",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521134",
            "telephone_number": "920-939-8868",
            "fax_number": "920-939-7042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1476 KENWOOD DR STE 102",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521134",
            "telephone_number": "920-939-8868",
            "fax_number": "920-939-7042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOURISHING CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-14",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A",
        "authorized_official_last_name": "TAAKE",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "MEGAN",
        "authorized_official_title_or_position": "OWNER/ THERAPIST",
        "authorized_official_telephone_number": "920-939-8868",
        "authorized_official_credential": "LPC, SAC"
    },
    "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": []
}

Other providers in Menasha, WI

Sources for this page

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