La Shanda Tolefree, BA, MS | |
3536 52nd St, Kenosha, WI 53144-2662 | |
(262) 842-0538 | |
(262) 842-0539 |
Full Name | La Shanda Tolefree |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 3536 52nd St, Kenosha, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003350422 | NPI | - | NPPES |
100227567 | Medicaid | WI | |
17018131 | Other | WI | SUBSTANCE ABUSE COUNSELOR |
8095125 | Other | WI | LICENSED PROFESSIONAL COUNSELOR |
Entity Name | Kenosha Human Development Services, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1942470661 PECOS PAC ID: 0143467720 Enrollment ID: O20130520000465 |
Mailing Address | Practice Location Address |
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La Shanda Tolefree, BA, MS 3536 52nd St, Kenosha, WI 53144-2662 Ph: (262) 842-0538 | La Shanda Tolefree, BA, MS 3536 52nd St, Kenosha, WI 53144-2662 Ph: (262) 842-0538 |
Ann M Grossman, MS, LPC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 6321 23rd Ave, Kenosha, WI 53143 Phone: 414-455-3879 Fax: 866-719-3024 | |
Stephanie L Mayberry, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 6127 Green Bay Rd Ste 200, Kenosha, WI 53142 Phone: 262-654-8366 Fax: 262-842-0444 | |
Jami Lynn Pomeroy, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1400 75th St, Kenosha, WI 53143 Phone: 262-909-6008 | |
Kathleen M Bullard, MS, LPC-IT, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 4003 80th St Ste 101, Kenosha, WI 53142 Phone: 262-806-1467 Fax: 262-661-7702 | |
Monica Christian, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2108 63rd St, Kenosha, WI 53143 Phone: 262-652-2406 | |
Jessica Martzahl, LPC Counselor Medicare: Medicare Enrolled Practice Location: 2108 63rd St, Kenosha, WI 53143 Phone: 262-652-2406 |