| Abundant Life Counseling & Renewal Center Llc | |
|
3049 Ramada Way Ste 200 Green Bay WI 54304-5576 | |
| (920) 482-2932 | |
| Not Available |
| Full Name | Abundant Life Counseling & Renewal Center Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3049 Ramada Way Ste 200, Green Bay, Wisconsin |
| Authorized Official Name and Position | Joann Nitka (OWNER) |
| Authorized Official Contact | 9204822932 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abundant Life Counseling & Renewal Center Llc 3049 Ramada Way Ste 200 Green Bay WI 54304-5576 Ph: (920) 482-2932 | Abundant Life Counseling & Renewal Center Llc 3049 Ramada Way Ste 200 Green Bay WI 54304-5576 Ph: (920) 482-2932 |
| NPI Number | 1801283494 |
|---|---|
| Provider Enumeration Date | 04/21/2015 |
| Last Update Date | 02/06/2024 |
| Certification Date | 02/06/2024 |
| Medicare PECOS PAC ID | 6305154105 |
|---|---|
| Medicare Enrollment ID | O20150928002573 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801283494 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Joann M Nitka |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487724647 PECOS PAC ID: 8224346788 Enrollment ID: I20151001003045 |
| Provider Name | Janna Ruth Nordeman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245846195 PECOS PAC ID: 0446653224 Enrollment ID: I20210730003064 |
| Provider Name | Amber Marie Teele |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760910004 PECOS PAC ID: 7214388461 Enrollment ID: I20240111003911 |
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