| Lighthouse Clinic, Llc | |
|
2524 E Webster Pl Suite 203 Milwaukee WI 53211-4256 | |
| (414) 964-9200 | |
| (414) 964-4816 |
| Full Name | Lighthouse Clinic, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2524 E Webster Pl, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Paula Tudorof (OWNER/MANAGER) |
| Authorized Official Contact | 3234479507 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Clinic, Llc 2524 E Webster Pl Ste 203 Milwaukee WI 53211-4257 Ph: (414) 964-9200 | Lighthouse Clinic, Llc 2524 E Webster Pl Suite 203 Milwaukee WI 53211-4256 Ph: (414) 964-9200 |
| NPI Number | 1912216219 |
|---|---|
| Provider Enumeration Date | 10/04/2010 |
| Last Update Date | 09/02/2025 |
| Certification Date | 02/21/2024 |
| Medicare PECOS PAC ID | 4385826502 |
|---|---|
| Medicare Enrollment ID | O20110309000822 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912216219 | NPI | - | NPPES |
| Provider Name | Susan M Doerflinger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710092960 PECOS PAC ID: 5496648826 Enrollment ID: I20040207000306 |
| Provider Name | Maria I Mas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083703060 PECOS PAC ID: 4385625722 Enrollment ID: I20040601000294 |
| Provider Name | William H Davies |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225242357 PECOS PAC ID: 8426015843 Enrollment ID: I20041216000580 |
| Provider Name | Darcy A Mcdaniel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508989617 PECOS PAC ID: 5395797518 Enrollment ID: I20050216000465 |
| Provider Name | Jade M Mueller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235242744 PECOS PAC ID: 1052337037 Enrollment ID: I20051019000398 |
| Provider Name | Kristine L Howley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396852919 PECOS PAC ID: 8123118015 Enrollment ID: I20071215000058 |
| Provider Name | Jan C Vanschaik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649381849 PECOS PAC ID: 9638254246 Enrollment ID: I20080306000507 |
| Provider Name | Louann B Mueller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730281999 PECOS PAC ID: 3274606322 Enrollment ID: I20080722000657 |
| Provider Name | Andrea Phyliis Janis-towey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649341207 PECOS PAC ID: 8820274988 Enrollment ID: I20110525000646 |
| Provider Name | Nathaniel L Ray |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275776270 PECOS PAC ID: 6608018213 Enrollment ID: I20130812000319 |
| Provider Name | Laura W O'loughlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588081913 PECOS PAC ID: 8123242443 Enrollment ID: I20140606000975 |
| Provider Name | Krin S Kramer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770976136 PECOS PAC ID: 7517262892 Enrollment ID: I20160224001701 |
| Provider Name | Mary Bultman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639627110 PECOS PAC ID: 4486934668 Enrollment ID: I20161205001423 |
| Provider Name | Steven Eigen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104912666 PECOS PAC ID: 7517344518 Enrollment ID: I20220512001956 |
| Provider Name | Joanna Buck |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912403700 PECOS PAC ID: 3870916935 Enrollment ID: I20220818001585 |
| Provider Name | Stacey Sievert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326485145 PECOS PAC ID: 3971948068 Enrollment ID: I20240228003065 |
| Provider Name | Vicky L Spaulding Lpc |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770911869 PECOS PAC ID: 1355787755 Enrollment ID: I20240307002635 |
| Provider Name | Madisen J Stoler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346866910 PECOS PAC ID: 3173961778 Enrollment ID: I20240402001328 |
| Provider Name | Misty M Christensen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275047367 PECOS PAC ID: 6800234410 Enrollment ID: I20240402001768 |
| Provider Name | Ryan D Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063112597 PECOS PAC ID: 7113365354 Enrollment ID: I20240405002924 |
| Provider Name | Sara M Goetz |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1144766239 PECOS PAC ID: 7517306376 Enrollment ID: I20240412004016 |
| Provider Name | Daniel L Huber |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457394488 PECOS PAC ID: 6507835964 Enrollment ID: I20240418000765 |
| Provider Name | Necha D Jacob |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235891581 PECOS PAC ID: 8426499047 Enrollment ID: I20240514003096 |
| Provider Name | Rhionna M Jubert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710609409 PECOS PAC ID: 4082151345 Enrollment ID: I20240805000436 |
| Provider Name | Dawn M Mayer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194530949 PECOS PAC ID: 9830616978 Enrollment ID: I20250512002275 |
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