Full Life Counseling Center

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

FULL LIFE COUNSELING CENTER

Practice address

9764 N Arrowwood Rd
Mequon, WI 53092-4703

Phone

(407) 529-7662

NPI assigned

Oct 30, 2024

Last updated

Oct 30, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bruna Medeiros Lupo, LMHC, LPCNPI 1538678966

Title

Owner and Clinician

Phone

(407) 529-7662

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, and the practitioner matching its NPPES authorized official.

• Bruna Medeiros Lupo

  • Mental Health Counselor
  • Mequon, WI
  • NPI 1538678966
  NPD Authorized official

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

{
    "created_epoch": "1730246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1841012846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1347 SIMMONS RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347445629",
            "telephone_number": "407-529-7662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9764 N ARROWWOOD RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530924703",
            "telephone_number": "407-529-7662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL LIFE COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-30",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "MEDEIROS LUPO",
        "authorized_official_first_name": "BRUNA",
        "authorized_official_title_or_position": "OWNER AND CLINICIAN",
        "authorized_official_telephone_number": "407-529-7662",
        "authorized_official_credential": "LMHC, LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.
• Froedtert Health Neighborhood Hospital, LLC (Froedtert Community Hospital)
• Froedtert Health Pharmacy LLC (Froedtert Pharmacy 300)
• Froedtert Memorial Lutheran Hospital, Inc. (Froedtert & MCW Mequon Health Center Remote Dispensing Site)
• Kelly Froemke
• Deborah Lee Gall
• Gary M Gallitz, LPC
• Alexandra Galmore
• Masoud Ganji, MD
• Corey F Garber, LPC, SAC-T

• Mental Health Clinic/Center (Including Community Mental Health Center) in Mequon, WI
• Providers in Mequon, WI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.