Samantha B Kesting, LPC-IT | |
112 Peace Lutheran Pkwy, Hartford, WI 53027-1159 | |
(800) 438-1772 | |
(262) 293-9737 |
Full Name | Samantha B Kesting |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 112 Peace Lutheran Pkwy, Hartford, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1558874180 | NPI | - | NPPES |
100073005 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 8406-125 (Wisconsin) | Primary |
101YP2500X | Counselor - Professional | 3741-226 (Wisconsin) | Secondary |
Entity Name | Wisconsin Lutheran Child And Family Service Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083786628 PECOS PAC ID: 0749233898 Enrollment ID: O20050301000318 |
Mailing Address | Practice Location Address |
---|---|
Samantha B Kesting, LPC-IT W175n11120 Stonewood Dr, Germantown, WI 53022-6511 Ph: (800) 438-1772 | Samantha B Kesting, LPC-IT 112 Peace Lutheran Pkwy, Hartford, WI 53027-1159 Ph: (800) 438-1772 |
Mrs. Jean M Meidenbauer, MS LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 635 Mueller St, Hartford, WI 53027 Phone: 262-224-7006 Fax: 262-397-8023 | |
Mrs. Jennifer Everts, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 620 Pleasant Ave, Hartford, WI 53027 Phone: 262-457-1121 | |
Jamie Lynn Velvikis, CSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 384 W Sumner St, Hartford, WI 53027 Phone: 262-323-1055 Fax: 262-323-1055 | |
Mr. Gary Robert Probst, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 384 W Sumner St, Hartford, WI 53027 Phone: 262-244-0729 Fax: 866-238-3845 | |
Jill Bley Klink, LPC Counselor Medicare: Medicare Enrolled Practice Location: 1640 E Sumner St, Hartford, WI 53027 Phone: 262-670-4069 | |
Briana Roberts, Counselor Medicare: Not Enrolled in Medicare Practice Location: 384 W Sumner St, Hartford, WI 53027 Phone: 262-223-6125 |