Lynette Gunville, MED | |
721 American Ave, Suite 501, Waukesha, WI 53188 | |
(262) 928-2396 | |
(262) 544-1213 |
Full Name | Lynette Gunville |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 721 American Ave, Waukesha, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1750419875 | NPI | - | NPPES |
43586100 | Medicaid | WI | |
2982125 | Other | WI | LPC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | 2982125 (Wisconsin) | Secondary |
101YP2500X | Counselor - Professional | 2982 (Wisconsin) | Primary |
Entity Name | Prohealth Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356322440 PECOS PAC ID: 3476465188 Enrollment ID: O20031103000066 |
Mailing Address | Practice Location Address |
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Lynette Gunville, MED 721 American Ave, Suite 501, Waukesha, WI 53188 Ph: (262) 928-2396 | Lynette Gunville, MED 721 American Ave, Suite 501, Waukesha, WI 53188 Ph: (262) 928-2396 |
Stephanie Pattengale, LPC Counselor Medicare: Medicare Enrolled Practice Location: 721 American Ave, Ste 501, Waukesha, WI 53188 Phone: 262-928-4036 | |
Lisa Beth Moore, LPC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 101 W Broadway Fl 2, Waukesha, WI 53186 Phone: 262-547-5567 | |
Brittany Witty, LPC Counselor Medicare: Medicare Enrolled Practice Location: 741 N Grand Ave Ste 302, Waukesha, WI 53186 Phone: 262-789-1191 | |
Daniel E Hermsen, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: W231 N1440 Corporate Court, Suite 310, Waukesha, WI 53186 Phone: 282-896-6186 Fax: 262-896-6139 | |
Jayne Weyer-smith, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 707 W Moreland Blvd, Suite 5, Waukesha, WI 53188 Phone: 262-542-0123 Fax: 262-542-1199 | |
Amanda J Dowling, PCIT Counselor Medicare: Not Enrolled in Medicare Practice Location: 721 American Ave Ste 501, Waukesha, WI 53188 Phone: 262-928-4036 Fax: 262-928-5096 | |
Jill M Bibler, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 721 American Ave, Suite 501, Waukesha, WI 53188 Phone: 262-928-2396 Fax: 262-544-1213 |