Lakefront Wellness Center, Sc in Pewaukee - Clinical
Lakefront Wellness Center, Sc - NPI 1316024847
Lakefront Wellness Center, Sc is a Clinical in Pewaukee, Wisconsin. Lakefront Wellness Center, Sc practices all healthcare services and medical treatments related to Clinical. The NPI Number for Lakefront Wellness Center, Sc is 1316024847. The last update date is 2013-08-27.
Lakefront Wellness Center, Sc's current location address is 161 W Wisconsin Ave Ste 2b, Pewaukee, Wisconsin. You can contact this provider via phone number 2626958857 and fax number 2626958879. The mailing address for Lakefront Wellness Center, Sc is 161 W Wisconsin Ave Ste 2b, Pewaukee, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lakefront Wellness Center, Sc |
|---|---|
| Address | 161 W Wisconsin Ave Ste 2b, Pewaukee, Wisconsin |
| Phone Number | 2626958857 |
| Fax Number | 2626958879 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DIRECTOR |
|---|---|
| Authorized Official Name | Johnson A. Beth |
| Credentials | PSY.D. |
| Telephone Number | 2626958857 |
NPI Number Detail
| NPI Number | 1316024847 |
|---|---|
| Provider Enumeration Date | 2006-11-01 |
| Last Updated Date | 2013-08-27 |
Provider Mailing Address Detail
| Address | 161 W Wisconsin Ave Ste 2b |
|---|---|
| City | Pewaukee |
| State | Wisconsin (WI) |
| Post Code | 530723468 |
| Phone Number | 2626958857 |
| Fax Number | 2626958879 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 2437 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 42230900 | WI | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Lakefront Wellness Center, Sc by the Centers for Medicare & Medicaid Services?
The Lakefront Wellness Center, Sc has been assigned the NPI (National Provider Identifier) 1316024847 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Can you provide the Lakefront Wellness Center, Sc's physical address?
The Lakefront Wellness Center, Sc is physically located at 161 W Wisconsin Ave Ste 2B, in the city of Pewaukee, WI, with the postal code 530723468.
What is Lakefront Wellness Center, Sc's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Lakefront Wellness Center, Sc is Clinical, and the corresponding taxonomy classification code for this specialized field is 103Tc0700X.
On what date did the Lakefront Wellness Center, Sc receive its 1316024847 assignment from the Centers for Medicare & Medicaid Services?
The Lakefront Wellness Center, Sc was assigned its 1316024847 by the Centers for Medicare & Medicaid Services on 2006-11-01.
As of what date were the Lakefront Wellness Center, Sc's details last updated?
The information pertaining to the Lakefront Wellness Center, Sc, including its address, specialty, and other details, was most recently updated on 2013-08-27.