Wellformed AI

NPI 1972354504 · live from the CMS NPI Registry

Beyond Wellness PLLC

Clinic/Center, Mental Health (Including Community Mental Health Center) in Milwaukee, WI. National Provider Identifier 1972354504, active.

NPI record

NPI1972354504 Type 2 · organization
StatusActive
Primary specialtyClinic/Center, Mental Health (Including Community Mental Health Center) 261QM0801X
Practice location7384 N 60th St, Milwaukee, WI 53223
Practice phone833-759-8720
Mailing addressPo Box 30085, Las Vegas, NV 89173
EnumeratedApril 1, 2024
Last updatedJanuary 27, 2025
Authorized officialLisa Anderson, President

Taxonomies and licenses

TaxonomyCodeLicense
Counselor, Addiction (Substance Use Disorder)101YA0400X—
Counselor, Mental Health101YM0800X—
Behavior Analyst103K00000X—
Social Worker, Clinical1041C0700X—
Nutritionist, Nutrition, Education133NN1002X—
Dietitian, Registered133V00000X—
Clinic/Center, Mental Health (Including Community Mental Health Center) primary261QM0801X—
Clinic/Center, Multi-Specialty261QM1300X—
Clinic/Center, Primary Care261QP2300X—

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.