| Lake Country Counseling Service | |
|
325 Forest Grove Dr Ste. 201 Pewaukee WI 53072-3793 | |
| (262) 719-9470 | |
| (262) 691-2972 |
| Full Name | Lake Country Counseling Service |
|---|---|
| Speciality | Counselor - Professional |
| Location | 325 Forest Grove Dr, Pewaukee, Wisconsin |
| Authorized Official Name and Position | Jefferson David Ferguson (OWNER/CHILD AND FAMILY THERAPIST) |
| Authorized Official Contact | 2626912982 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Country Counseling Service 325 Forest Grove Dr Ste. 201 Pewaukee WI 53072-3793 Ph: (262) 719-9470 | Lake Country Counseling Service 325 Forest Grove Dr Ste. 201 Pewaukee WI 53072-3793 Ph: (262) 719-9470 |
| NPI Number | 1831328533 |
|---|---|
| Provider Enumeration Date | 07/02/2009 |
| Last Update Date | 07/02/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831328533 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 3487125 (Wisconsin) | Primary |
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