Organization Active NPI

Wellmind Collaborative LLC

  • Clinical Social Worker
  • Brookfield, WI
National Provider Identifier
1689534422
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
WELLMIND COLLABORATIVE LLC
Practice address
14530 W Capitol Dr
Ste 103
Brookfield, WI 53005
Phone
(414) 373-5611
NPI assigned
Nov 14, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Authorized official

Name
Jennifer Lee Zickuhr, APSW
Title
Clinical Social Worker/Owner
Phone
(414) 373-5611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

14530 W Capitol Dr
Ste 103
Brookfield, WI 53005

Mailing address

12605 W North Avenue
#146
Brookfield, WI 53005-4929
Phone (414) 373-5611

National Provider Directory

National Provider Directory

Locations

14530 W Capitol Dr
Ste 103
Brookfield, WI 53005
Phone (414) 373-5611

NPI Registry JSON

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

{
    "created_epoch": "1763078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763078400000",
    "number": "1689534422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12605 W NORTH AVENUE",
            "address_2": "#146",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054929",
            "telephone_number": "414-373-5611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14530 W CAPITOL DR",
            "address_2": "STE 103",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "53005",
            "telephone_number": "414-373-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLMIND COLLABORATIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-14",
        "last_updated": "2025-11-14",
        "status": "A",
        "authorized_official_last_name": "ZICKUHR",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER/OWNER",
        "authorized_official_telephone_number": "414-373-5611",
        "authorized_official_credential": "APSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; 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.