| Lakeside Family Therapy Services Ltd | |
|
4810 Northwestern Ave Racine WI 53406 | |
| (262) 637-9984 | |
| (262) 637-9995 |
| Full Name | Lakeside Family Therapy Services Ltd |
|---|---|
| Speciality | Clinic/Center |
| Location | 4810 Northwestern Ave, Racine, Wisconsin |
| Authorized Official Name and Position | Jacqueline V Mcrae (PRESIDENT) |
| Authorized Official Contact | 2626379984 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Family Therapy Services Ltd 4810 Northwestern Ave Racine WI 53406-1504 Ph: (262) 637-9984 | Lakeside Family Therapy Services Ltd 4810 Northwestern Ave Racine WI 53406 Ph: (262) 637-9984 |
| NPI Number | 1407998719 |
|---|---|
| Provider Enumeration Date | 02/13/2007 |
| Last Update Date | 08/06/2021 |
| Certification Date | 08/06/2021 |
| Medicare PECOS PAC ID | 3678756400 |
|---|---|
| Medicare Enrollment ID | O20110331000546 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407998719 | NPI | - | NPPES |
| 42120700 | Medicaid | WI |
| Provider Name | Susan E Moore Schneider |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104901222 PECOS PAC ID: 5799721346 Enrollment ID: I20071108000100 |
| Provider Name | Renee M Beck-santiago |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912276858 PECOS PAC ID: 7810157799 Enrollment ID: I20120330000184 |
| Provider Name | Karla J Bidstrup |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437485984 PECOS PAC ID: 3375772312 Enrollment ID: I20140214001016 |
| Provider Name | Daniel Dashner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144621376 PECOS PAC ID: 5698050573 Enrollment ID: I20170315001213 |
| Provider Name | Jelena Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699232546 PECOS PAC ID: 7416352612 Enrollment ID: I20210826001443 |
Dynamic Potential Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 316 5th St Ste 2, Racine, WI 53403 Phone: 262-308-8085 | |
Aneu Beginning Llc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3801 Monarch Dr, Racine, WI 53406 Phone: 262-497-3445 | |
Christian Family Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6150 Taylor Avenue, Racine, WI 53403 Phone: 800-438-1772 Fax: 262-293-9737 | |
Mwa Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4425 Taylor Ave, Racine, WI 53405 Phone: 262-554-1400 | |
Professional Services Group, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 Goold St, Racine, WI 53402 Phone: 262-638-2000 Fax: 262-638-2006 | |
Genesis Behavioral Services, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4107 Saint Clair St, Racine, WI 53402 Phone: 414-939-7145 Fax: 414-321-5935 | |
Transitional Living Services, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3710 Douglas Ave, Racine, WI 53402 Phone: 262-639-8084 Fax: 262-639-8086 |