| Lighthouse Counseling Services, Llc | |
|
353 Forest Grove Dr Ste 100 Pewaukee WI 53072-3765 | |
| (262) 719-9470 | |
| (262) 691-2972 |
| Full Name | Lighthouse Counseling Services, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 353 Forest Grove Dr Ste 100, Pewaukee, Wisconsin |
| Authorized Official Name and Position | Jefferson D Ferguson (THERAPIST/CO-OWNER) |
| Authorized Official Contact | 2627199470 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Counseling Services, Llc 353 Forest Grove Dr Ste 100 Pewaukee WI 53072-3765 Ph: (262) 719-9470 | Lighthouse Counseling Services, Llc 353 Forest Grove Dr Ste 100 Pewaukee WI 53072-3765 Ph: (262) 719-9470 |
| NPI Number | 1821799370 |
|---|---|
| Provider Enumeration Date | 03/13/2023 |
| Last Update Date | 09/10/2024 |
| Certification Date | 09/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821799370 | NPI | - | NPPES |
| 40965300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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