MEDICARE: INTEGRATED WELLNESS CONSULTING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	133N00000X	Nutritionist
3	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1013806348
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED WELLNESS CONSULTING LLC

Provider Business Mailing Address
First Line	:	301 HIGH POINTE LN
Second Line	:
City	:	NEPTUNE
State	:	NJ
Zip	:	07753-2771
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 HIGH POINTE LN
Second Line	:
City	:	NEPTUNE
State	:	NJ
Zip	:	07753-2771
Country	:	US
Telephone Number	:	718-755-1507
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN CAMPETELLA
Credential	:
Telephone Number	:	187-551-5077

Provider Enumeration Date	:	07/01/2025
Last Update Date	:	12/26/2025

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