Divine Wellness & Counseling, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

DIVINE WELLNESS & COUNSELING, LLC

Practice address

5205 N Ironwood Rd Ste 117
Glendale, WI 53217-4907

Phone

(414) 502-9355

Fax

(414) 396-4101

NPI assigned

Jan 14, 2019

Organization subpart

No

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

Authorized official

Name

Donetta Walker, LPC

Title

LPC/ Owner

Phone

(414) 502-9355

Specialties & licenses 1

Addresses

Practitioners 1

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

• Shakari Lewis, LPC

  • Professional Counselor
  • Glendale, WI
  • NPI 1821658626
  NPD (past)

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547424000000",
    "number": "1790259703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5205 N IRONWOOD RD STE 117",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 N IRONWOOD RD STE 117",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174907",
            "telephone_number": "414-502-9355",
            "fax_number": "414-396-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE WELLNESS & COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-14",
        "last_updated": "2019-01-14",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "DONETTA",
        "authorized_official_title_or_position": "LPC/ OWNER",
        "authorized_official_telephone_number": "414-502-9355",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kari Lynn Di Fonzo, LCSW,
• Kayla Diesner
• Digitrace Care Services, Inc
• Dimitrios P Bousounis MD
• Divine Horizon Pmhnp Services, LLC
• Jasmine Dockery, PHARMD
• Steven J. Donatello, M.D.
• Leah Taylor Donovan, R.N., A.P.N.P.
• William C. Dowsett, DDS
• David Drapes, PHD

• Professional Counselor in Glendale, WI
• Providers in Glendale, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; 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.