| Lakeview Mill Pond | |
|
1701 Sharp Rd Waterford WI 53185-5214 | |
| (262) 534-7297 | |
| (262) 534-7257 |
| Full Name | Lakeview Mill Pond |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
| Location | 1701 Sharp Rd, Waterford, Wisconsin |
| Authorized Official Name and Position | Andy Olivares (PRESIDENT/COO) |
| Authorized Official Contact | 2625347297 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeview Mill Pond 1701 Sharp Rd Waterford WI 53185-5214 Ph: (262) 534-7297 | Lakeview Mill Pond 1701 Sharp Rd Waterford WI 53185-5214 Ph: (262) 534-7297 |
| NPI Number | 1083924732 |
|---|---|
| Provider Enumeration Date | 10/15/2010 |
| Last Update Date | 03/29/2024 |
| Certification Date | 03/29/2024 |
| Medicare PECOS PAC ID | 0840460259 |
|---|---|
| Medicare Enrollment ID | O20110823000148 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083924732 | NPI | - | NPPES |
| Provider Name | Bruce A Semon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114020773 PECOS PAC ID: 3971498866 Enrollment ID: I20040219000202 |
| Provider Name | Cynthia D Sorenson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518004753 PECOS PAC ID: 1355376013 Enrollment ID: I20050930000412 |
| Provider Name | Patti A Wagner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396255774 PECOS PAC ID: 3870035694 Enrollment ID: I20240607003371 |
My Time Counseling Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7957 W Wind Lake Rd Ste E, Waterford, WI 53185 Phone: 262-698-0991 | |
Paruszkiewicz Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 117 S River St, Waterford, WI 53185 Phone: 262-210-6739 |