Wholehearted Integrative Bodymind Therapies LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

WHOLEHEARTED INTEGRATIVE BODYMIND THERAPIES LLC

Practice address

1035 W Glen Oaks LN Ste 204
Mequon, WI 53092-3395

Phone

(414) 858-8085

NPI assigned

Jul 4, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Nicole L Bickham, PHDNPI 1134666514

Title

Owner

Phone

(414) 858-8085

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

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

• Nicole L Bickham, PH.D.

  • Psychologist
  • Mequon, WI
  • NPI 1134666514
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1530662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738540800000",
    "number": "1891281606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 LAVERNE DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543115931",
            "telephone_number": "414-858-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 W GLEN OAKS LN STE 204",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923395",
            "telephone_number": "414-858-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLEHEARTED INTEGRATIVE BODYMIND THERAPIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-04",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A",
        "authorized_official_last_name": "BICKHAM",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-858-8085",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100072756",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan E Weiss, LPC
• Grace Welch
• Melissa J Westendorf, J.D./PH.D.
• Mackenzie Jensen Wheeler, DPT
• Bonnie L. White, MA, SAC-IT
• Mary Beth Wick, O.T.R.
• Laila Wiechmann
• Christine Wielgos, LCSW
• Nancy Wiener, PT
• Emily Wilde

• Psychologist in Mequon, WI
• Providers in Mequon, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.