Amber Marie Teele, LPC, SAC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

8037-125 Issued in WI

Practice address

3049 Ramada Way Ste 200
Green Bay, WI 54304-5576

Phone

(920) 482-2932

Fax

(800) 892-6147

NPI assigned

May 31, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Miss Amber Marie Grovogel Former name

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Abundant Life Counseling and Renewal Center LLCGroup PAC ID 6305154105, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Abundant Life Counseling & Renewal Center LLC

  • Community/Behavioral Health Agency
  • Green Bay, WI
  • NPI 1801283494
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1760910004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3049 RAMADA WAY STE 200",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045576",
            "telephone_number": "920-482-2932",
            "fax_number": "800-892-6147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3049 RAMADA WAY STE 200",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045576",
            "telephone_number": "920-482-2932",
            "fax_number": "800-892-6147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEELE",
        "first_name": "AMBER",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LPC, SAC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-31",
        "last_updated": "2024-02-05",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16424-131",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "8037-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760910004",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "GROVOGEL",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "SAC-IT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tanner Nichole Taylor, OD
• Angela Marie Tayson, MA, LPC
• David Seeger Tearse, MD
• Carli Megan Tebo, LAT
• Sheila M Teddy
• Merle L Teetzen, MD
• Frank H Teller, LCSW
• Megan E Temp, M.D.
• Mary A Templin, NP
• Marcia A Ten Haken, CNM, APNP

• Mental Health Counselor in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.