NPI 1053297697 · live from the CMS NPI Registry
A Fresh Start Counseling And Wellness LLC
Social Worker, Clinical in Green Bay, WI. National Provider Identifier 1053297697, active.
NPI record
| NPI | 1053297697 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 916 Willard Dr Ste 125f, Green Bay, WI 54304 |
| Practice phone | 920-798-8480 |
| Enumerated | August 11, 2025 |
| Last updated | August 11, 2025 |
| Authorized official | Lisa Burke, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical primary | 1041C0700X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.