| 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 |
| 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 | Yes. This clinic participates in medicare program and accept medicare insurance. |
| 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 |
| Medicare PECOS PAC ID | 1456880020 |
|---|---|
| Medicare Enrollment ID | O20250128000533 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821799370 | NPI | - | NPPES |
| 40965300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Judith Marie Crabb |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164727509 PECOS PAC ID: 3274062849 Enrollment ID: I20250128000653 |
| Provider Name | Hanna Bakken |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760193494 PECOS PAC ID: 4981134152 Enrollment ID: I20250204002171 |
| Provider Name | Megan Nicole Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699468769 PECOS PAC ID: 6901336189 Enrollment ID: I20250204002519 |
| Provider Name | Jefferson David Ferguson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164533147 PECOS PAC ID: 4183153752 Enrollment ID: I20250303002697 |
| Provider Name | Kevin Robert O'connor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447943832 PECOS PAC ID: 7517480163 Enrollment ID: I20250325001727 |
| Provider Name | Joy Ramme |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871190819 PECOS PAC ID: 0941723506 Enrollment ID: I20250325001869 |
| Provider Name | Brittany Hablewitz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659857381 PECOS PAC ID: 3577086149 Enrollment ID: I20250325002255 |
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