Total Life Wellness PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

TOTAL LIFE WELLNESS PLLC

Doing business as

Total Life Wellness PLLC

Practice address

823 Sheridan LN
Waterloo, IL 62298-3366

Phone

(618) 616-4535

NPI assigned

Sep 8, 2022

Organization subpart

No

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

Authorized official

Name

Kara Bordeaux, MA LCPCNPI 1811355928

Title

Executive Director

Phone

(618) 616-4535

Specialties & licenses 1

Addresses

Other names 1

• Total Life Wellness PLLC Doing business as

Electronic endpoints 1

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.

• Kara Bordeaux, M.A., L.P.C.

  • Counselor
  • Waterloo, IL
  • NPI 1811355928
  NPD Authorized official

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

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662595200000",
    "number": "1982325874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 SHERIDAN LN",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622983366",
            "telephone_number": "618-616-4535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 SHERIDAN LN",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622983366",
            "telephone_number": "618-616-4535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL LIFE WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A",
        "authorized_official_last_name": "BORDEAUX",
        "authorized_official_first_name": "KARA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-616-4535",
        "authorized_official_credential": "MA LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "SimplePractice",
            "affiliation": "N",
            "endpointDescription": "SimplePracitce",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Simple Practice",
            "address_1": "823 sheridan ln",
            "city": "waterloo",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Total Life Wellness PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James S Sweeney, MSW
• Trisha Talamantes, RSA
• Jamil Mousa Tannous, D.C.,
• The Body Works Physical Therapy and Wellness PC
• Robert L Toal Jr., OD
• Jennifer Tourville, MHP
• Transitions Counseling, LLC
• Dawn Amy Travelstead, LPN
• Elizabeth Turnbow, MHP
• Timothy Valentine, RSA

• Professional Counselor in Waterloo, IL
• Providers in Waterloo, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.