Ashlie Moelter, | |
101 Broad St Ste 201, Lake Geneva, WI 53147-2061 | |
(262) 248-7942 | |
(262) 248-1202 |
Full Name | Ashlie Moelter |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 101 Broad St Ste 201, Lake Geneva, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619473998 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 3631 (Wisconsin) | Primary |
Entity Name | Lake Geneva Wellness Clinic Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003845181 PECOS PAC ID: 7517139447 Enrollment ID: O20111018000668 |
Mailing Address | Practice Location Address |
---|---|
Ashlie Moelter, 6573 State Road 50, Lake Geneva, WI 53147-3645 Ph: (262) 607-0364 | Ashlie Moelter, 101 Broad St Ste 201, Lake Geneva, WI 53147-2061 Ph: (262) 248-7942 |
Ms. Valarie Jo Lura, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: N3251 Queen Rd, Lake Geneva, WI 53147 Phone: 262-248-0626 | |
Julie A Rice, LPC Counselor Medicare: Medicare Enrolled Practice Location: N2950 State Road 67, Lake Geneva, WI 53147 Phone: 800-637-2901 | |
Irene Corzo, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 772 Main St, Suite 203, Lake Geneva, WI 53147 Phone: 847-890-1369 | |
Jennifer Frye Keefe, M.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 166 E Geneva Sq, Lake Geneva, WI 53147 Phone: 262-249-0830 Fax: 262-249-0835 | |
Mr. Joseph Fairbanks, LPC, CEAP, NCC Counselor Medicare: Medicare Enrolled Practice Location: 146 E Geneva Sq, Lake Geneva, WI 53147 Phone: 877-666-7223 | |
Matthew Banas, Counselor Medicare: Not Enrolled in Medicare Practice Location: 750 Veterans Pkwy Unit 100, Lake Geneva, WI 53147 Phone: 262-248-7942 | |
Meggan Kathleen Lazzaroni, APSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 647 W Main St Ste 700, Lake Geneva, WI 53147 Phone: 262-729-3143 |