Embodied-Wellbeing Limited Liability Company

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

EMBODIED-WELLBEING LIMITED LIABILITY COMPANY

Practice address

2701 Larsen Rd # Ba109
Green Bay, WI 54303-4863

Phone

(920) 521-8940

NPI assigned

Dec 21, 2022

Last updated

May 27, 2023By 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

Mr. Keith Paul Neilitz, LPC

Title

Clinical Therapist

Phone

(920) 521-8940

Specialties & licenses 2

Addresses

Electronic endpoints 1

Tax ID family

Embodied-Wellbeing Limited Liability Company2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Embodied-Welllbeing

  • Professional Counselor
  • Green Bay, WI
  • NPI 1124730023
  NPD tax ID

Locations

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

{
    "created_epoch": "1671580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685145600000",
    "number": "1851003826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 LARSEN RD # BA109",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543034863",
            "telephone_number": "920-521-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 LARSEN RD # BA109",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543034863",
            "telephone_number": "920-521-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBODIED-WELLBEING LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-21",
        "last_updated": "2023-05-27",
        "certification_date": "2023-05-27",
        "status": "A",
        "authorized_official_last_name": "NEILITZ",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "920-521-8940",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.embodied-wellbeingllc.org",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "SimplePractice.com",
            "address_1": "2701 Larsen Rd # Ba109",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543034863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James Leigh Elm, O.D.
• Teresa Elm
• Tariq Elmadawy
• Unknown Elsa Kurian, DDS
• Muna Elsiddig, MD
• Embodied-Welllbeing
• Tucker Anthony Emerson, D.C.
• Kate Henniges Emme, SLP
• Ethan Errol Emmons, MD
• Lydia R Emnott, PA-C

• Professional Counselor in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2023; 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.