LAKESHORE CLINIC LTD (NPI# 1407925985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407925985 |
| Entity Type | Organization |
| Organization Name | LAKESHORE CLINIC LTD |
| Practice Address |
3970 N Oakland Ave Suite 502 Milwaukee WI 53211 |
| Practice Telephone | 4149629909 |
| Practice Fax Number | 4143328596 |
| Mailing Telephone | 4149629909 |
| Mailing Fax Number | 4143328596 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. PATRICIA K BRICENO (ADMINISTRATOR) |
| Authorized Official Telephone | 4149629909 |
| Authorized Official Credential | MS LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
1497 | WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 42106900 | 05 |
| Street Address |
3970 N OAKLAND AVE SUITE 502 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285695395 | Mark Randall Aschliman | Orthopaedic Surgery | 3970 N Oakland Ave, #501, Milwaukee, WI 53211 | 2006-03-29 |
| 1740723048 | Julie Eimers | Counselor | 3970 N Oakland Ave, Milwaukee, WI 53211 | 2016-11-18 |
| 1760786925 | David Dixon Mellencamp | Orthopaedic Surgery | 3970 N Oakland Ave, 300, Milwaukee, WI 53211-2265 | 2011-01-03 |
| 1659551455 | Anthony A Ferguson, M.d.,s.c. | Orthopaedic Surgery | 3970 N Oakland Ave, Suite 300, Milwaukee, WI 53211-2265 | 2007-11-08 |
| 1275713075 | Mark R Aschliman, M.d., S.c. | Orthopaedic Surgery | 3970 N Oakland Ave, Suite 300, Milwaukee, WI 53211-2265 | 2007-11-08 |
| 1558541359 | Donald K Middleton, M.d., S.c. | Orthopaedic Surgery | 3970 N Oakland Ave, Suite 300, Milwaukee, WI 53211-2265 | 2007-11-08 |
| 1053523779 | Charles J Trimberger | Social Worker | 3970 N Oakland Ave, Suite 502, Milwaukee, WI 53211-2265 | 2007-05-04 |
| 1831315597 | Patricia Marie D'auria | Counselor | 3970 N Oakland Ave, Suite 502, Milwaukee, WI 53211 | 2007-04-18 |
| 1235209875 | Patricia K Briceno | Social Worker | 3970 N Oakland Ave, Lakeshore Clinic Suite 502, Milwaukee, WI 53211 | 2006-11-09 |
| 1003848318 | Orthopaedic Consultants, LLP | Orthopaedic Surgery | 3970 N Oakland Ave, Suite 501, Milwaukee, WI 53211-2265 | 2006-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821602335 | Gabriella Caitrin Emanuele | Occupational Therapist | Harborchase of Shorewood, 1111 E Capitol Drive, Shorewood, WI 53211 | 2020-09-02 |
| 1710527783 | Sage Specialty Pharmacy Inc. | Pharmacy | 4001 N. Oakland Ave, Shorewood, WI 53211 | 2020-01-08 |
| 1861043952 | Rosina Bloomingdale Norton | Nurse Practitioner | 1921 E Harford Ave, Milwaukee, WI 53211 | 2019-09-20 |
| 1528556255 | Renee Reckelberg | Specialist/Technologist | 3409 North Downer Avenue, Pavilion, Suite 350, Milwaukee, WI 53211 | 2018-04-27 |
| 1700325602 | Wisconsin Vision, Inc. | Optometrist | 4163 N Oakland Ave, Shorewood, WI 53211 | 2017-02-13 |
| 1750827556 | Daniel Butz M.d., S.c. | Plastic Surgery | 2350 N Lake Dr Ste 304, Milwaukee, WI 53211 | 2017-01-17 |
| 1528517232 | Therese Simonis | Speech-Language Pathologist | 2390 N Lake Drive, Milwaukee, WI 53211 | 2016-09-23 |
| 1982075701 | Katie Michel | Specialist/Technologist | 3409 N. Downer Ave, Milwaukee, WI 53211 | 2015-10-20 |
| 1255776365 | Sarah Elizabeth Brill | Social Worker | 4433 N Oakland Ave Ste D, Shorewood, WI 53211 | 2013-05-02 |
| 1679814537 | Nicole Anne Parulski | Physical Therapist | 2301 North Lake Dr, Milwaukee, WI 53211 | 2013-03-01 |
| Find all providers in zip 53211 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316587439 | Sixteenth Street Community Health Centers, Inc. | Clinic/Center | 1635 W National Ave, Milwaukee, WI 53204-1130 | 2020-01-07 |
| 1689149700 | Birt Supportive Services LLC | Clinic/Center | 4868 N 89th St, Milwaukee, WI 53225-4106 | 2018-10-04 |
| 1285181735 | Aurora Family Services | Clinic/Center | 3200 W. Highland Blvd, Aurora Family Services, Milwaukee, WI 53210 | 2016-09-01 |
| 1679981328 | Life Changing Ministries Substance Abuse Services | Clinic/Center | 1134 W North Ave 2nd Floor, Milwaukee, WI 53205 | 2014-07-25 |
| 1962839589 | Shoreview Counseling Services | Clinic/Center | 4950 N 21st St, Lower Level, Milwaukee, WI 53209-5750 | 2013-09-27 |
| 1952608721 | Community Advocates, Inc | Clinic/Center | 4906 W Fond Du Lac Ave, Milwaukee, WI 53216-2325 | 2011-02-14 |
| 1841438769 | Counseling & Transition Center Inc | Clinic/Center | 3073 S. Chase Ave, Suite 326, Milwaukee, WI 53207 | 2009-01-30 |
| 1639193212 | Horizon Healthcare, Inc | Clinic/Center | 5408 W Burleigh St, Milwaukee, WI 53210-1624 | 2006-07-27 |
| 1053934034 | Heather Hart Kennedy, Lcsw, LLC | Clinic/Center | 1110 N Old World 3rd St Ste 401, Milwaukee, WI 53203-1117 | 2020-05-25 |
| 1033772058 | Different Shades of Healing, LLC | Clinic/Center | 6830 W Villard Ave Ste 190, Milwaukee, WI 53218-3968 | 2019-04-16 |
| Find all providers in MILWAUKEE | ||||
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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.