LAKE COUNTRY COUNSELING SERVICE (NPI# 1831328533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831328533 |
| Entity Type | Organization |
| Organization Name | LAKE COUNTRY COUNSELING SERVICE |
| Practice Address |
325 Forest Grove Dr Ste. 201 Pewaukee WI 53072-3793 |
| Practice Telephone | 2627199470 |
| Practice Fax Number | 2626912972 |
| Mailing Telephone | 2627199470 |
| Mailing Fax Number | 2626912972 |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2009-07-02 |
| Authorized Official Name | MR. JEFFERSON DAVID FERGUSON (OWNER/CHILD AND FAMILY THERAPIST) |
| Authorized Official Telephone | 2626912982 |
| Authorized Official Credential | MS, LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
3487125 | WI | Behavioral Health & Social Service Providers |
| Street Address |
325 FOREST GROVE DR STE. 201 |
| City | PEWAUKEE |
| State | WI |
| Zip Code | 53072-3793 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427115716 | Diane C Garrison | Psychologist | 325 Forest Grove Dr, Suite 201, Pewaukee, WI 53072-3793 | 2007-01-03 |
| 1194271874 | Barbara C Sieck LLC | Psychologist | 325 Forest Grove Dr, Suite 201, Pewaukee, WI 53072-3894 | 2016-08-31 |
| 1790153880 | Catherine Gierszewski | Counselor | 325 Forest Grove Dr, 201, Pewaukee, WI 53072-3894 | 2015-09-08 |
| 1942507231 | Erika J Wagner-martin | Counselor | 325 Forest Grove Dr, Ste 201, Pewaukee, WI 53072-3894 | 2011-02-22 |
| 1306172820 | Connie L Beaster | Counselor | 325 Forest Grove Dr, Suite 201, Pewaukee, WI 53072-3894 | 2009-10-19 |
| 1578732921 | Cynthia Ann Midcalf | Counselor | 325 Forest Grove Dr, Suite 201, Pewaukee, WI 53072-3793 | 2008-02-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740805423 | Froedtert Health Neighborhood Hospital, LLC | General Acute Care Hospital | 209 Pewaukee Rd, Pewaukee, WI 53072 | 2020-06-09 |
| 1871122556 | Mary Kofigah | Nurse Practitioner | 21150 W. Capital Dr., Brookfield, WI 53072 | 2020-04-05 |
| 1609436559 | Brianna Kelly Bates | Optometrist | 1440 Capitol Drive, Suite B, Pewaukee, WI 53072 | 2019-06-13 |
| 1932767316 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1440 Capital Drive, Suite B, Pewaukee, WI 53072 | 2019-05-31 |
| 1417426925 | Edward Dow | Psychologist | W268n1988 Shooting Star Road, Pewaukee, WI 53072 | 2018-11-14 |
| 1346664869 | Jane Sweney | Counselor | 325 Forest Grove Drive, Pewaukee, WI 53072 | 2014-02-05 |
| 1093082182 | Kristin Elizabeth Thieneman | Pharmacist | 443 Pewaukee Road, Pewaukee, WI 53072 | 2011-11-17 |
| 1922318393 | Ariane Machin | Psychologist | 161 W. Wisconsin Ave #2b, Pewaukee, WI 53072 | 2010-10-19 |
| 1083930879 | Scott Robert Borkenhagen | Student in an Organized Health Care Education/Training Program | 384 Willow Grove Dr., Unit D, Pewaukee, WI 53072 | 2010-04-19 |
| 1912174988 | Robert Thomas Lynch | Dentist | 234 Oakton Ave, Pewaukee, WI 53072 | 2008-05-09 |
| Find all providers in zip 53072 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598302911 | Hansen, LLC | Counselor | 353 Forest Grove Dr Ste 101, Pewaukee, WI 53072-3765 | 2019-12-04 |
| 1306212535 | Karen A. Snider | Counselor | W275n1203 Springhill Dr, Pewaukee, WI 53072-5331 | 2015-08-11 |
| 1346664869 | Jane Sweney | Counselor | 325 Forest Grove Drive, Pewaukee, WI 53072 | 2014-02-05 |
| 1245447770 | Stephanie Hall Delmore | Counselor | 1177 Quail Ct Ste 101, Pewaukee, WI 53072 | 2007-05-16 |
| 1588127245 | Emily Todd Raclaw | Counselor | N27w23960 Paul Rd Ste 5, Pewaukee, WI 53072-6327 | 2019-04-10 |
| 1093239212 | Ashley Thompson | Counselor | 161 W Wisconsin Ave Ste 2b, Pewaukee, WI 53072-3468 | 2017-07-30 |
| 1790153880 | Catherine Gierszewski | Counselor | 325 Forest Grove Dr, 201, Pewaukee, WI 53072-3894 | 2015-09-08 |
| 1932538303 | Angela Hook | Counselor | 2831 N Grandview Blvd, Suite 209, Pewaukee, WI 53072-5585 | 2013-11-06 |
| 1114285202 | Jessica Dawn Marie Corey | Counselor | 161 W Wisconsin Ave, Pewaukee, WI 53072-3467 | 2012-04-26 |
| 1306172820 | Connie L Beaster | Counselor | 325 Forest Grove Dr, Suite 201, Pewaukee, WI 53072-3894 | 2009-10-19 |
| Find all providers in PEWAUKEE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.