| Lakeshore Wellness And Recovery Inc | |
|
1519 E Washington St Ste A West Bend WI 53095-2615 | |
| (262) 305-9668 | |
| Not Available |
| Full Name | Lakeshore Wellness And Recovery Inc |
|---|---|
| Speciality | Counselor |
| Location | 1519 E Washington St Ste A, West Bend, Wisconsin |
| Authorized Official Name and Position | Lynn Nowak (PROFESSIONAL COUNSELOR / OWNER) |
| Authorized Official Contact | 2623059668 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeshore Wellness And Recovery Inc 1519 E Washington St Ste A West Bend WI 53095-2615 Ph: (262) 305-9668 | Lakeshore Wellness And Recovery Inc 1519 E Washington St Ste A West Bend WI 53095-2615 Ph: (262) 305-9668 |
| NPI Number | 1609355452 |
|---|---|
| Provider Enumeration Date | 08/13/2018 |
| Last Update Date | 11/02/2020 |
| Certification Date | 11/02/2020 |
| Medicare PECOS PAC ID | 9032520465 |
|---|---|
| Medicare Enrollment ID | O20201116002138 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609355452 | NPI | - | NPPES |
| 1962748624 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 15917-132 (Wisconsin) | Secondary |
| 101YP2500X | Counselor - Professional | 6584-125 (Wisconsin) | Primary |
| Provider Name | Ashley Elizabeth Birkholz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003271693 PECOS PAC ID: 0446595052 Enrollment ID: I20181228001403 |
Wild Hope Counseling & Wellness, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 215 N Main St Ste 204, West Bend, WI 53095 Phone: 262-343-8285 | |
Genesis Behavioral Services, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1626 Clarence Ct, West Bend, WI 53095 Phone: 262-338-8611 Fax: 262-338-3367 | |
Fresh Perspective Psychotherapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2395 W Washington St Ste 202, West Bend, WI 53095 Phone: 262-689-9203 | |
Washington County Mental Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 333 E Washington St, Suite 2100, West Bend, WI 53095 Phone: 262-335-4545 Fax: 262-335-6827 | |
Aro Counseling Centers, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1622 Chestnut St, West Bend, WI 53095 Phone: 262-338-9498 Fax: 262-338-9506 | |
Life Space Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 215 N Main St, Suite 201, West Bend, WI 53095 Phone: 920-960-7232 Fax: 920-923-2736 | |
Delta Counseling Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 155 N Main St Ste F, West Bend, WI 53095 Phone: 262-236-7102 |