Organization
MANIFEST WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER KLEKAMP LPC, SAC (OWNER, PROGRAM DIRECTOR)
(608) 982-7698
Entity
Organization
Contact information
Practice address
2010 EASTWOOD DR STE 102, MADISON, WI 53704-5387
(608) 291-3676
(608) 716-3156
Mailing address
2010 EASTWOOD DR STE 104, MADISON, WI 53704-5387
(608) 291-3676
(608) 716-3156
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
08/10/2023
Last updated
12/06/2024
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