LAKESHORE PROFESSIONAL COUNSELING INC (NPI# 1831272574) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831272574 |
| Entity Type | Organization |
| Organization Name | LAKESHORE PROFESSIONAL COUNSELING INC |
| Other Organization Name | ALPHA OMEGA VENTURE |
| Practice Address |
447 First Street Menominee MI 49858-3307 |
| Practice Telephone | 9068642590 |
| Practice Fax Number | 9068643058 |
| Mailing Telephone | 9068642590 |
| Mailing Fax Number | 9068643058 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JEANNE M HARPER (CLINIC DIRECTOR) |
| Authorized Official Telephone | 9068642590 |
| Authorized Official Credential | MPS, FT, BCETS, |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 1500 | WI | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 42204000 | 05 | |
| WI | OUTPATIENT MENTAL HEALTH | 1500 | 01 |
| Other Name | Type Code |
|---|---|
| Alpha Omega Venture | Former Legal Business Name - Organization |
| Street Address |
447 FIRST STREET |
| City | MENOMINEE |
| State | MI |
| Zip Code | 49858-3307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942843800 | Lynnette Marie Geib | Technician | N1872 Hwy M-35, Menominee, MI 49858 | 2019-10-23 |
| 1669955514 | Corrina Rae Anderson | Behavior Technician | 1104 16th Ave, Menominee, MI 49858 | 2018-09-06 |
| 1740668565 | Eyecare Services, LLC | Voluntary or Charitable | 3400 North 10th St #73, Menominee, MI 49858 | 2015-05-13 |
| 1922300714 | Great Lakes Recovery Centers, Inc. | Community/Behavioral Health | 3120 10th Street, Suite 2, Menominee, MI 49858 | 2010-11-30 |
| 1295043651 | Andrew John Thanos | Dentist | 1201 10th Street, Menominee, MI 49858 | 2010-09-20 |
| 1962645226 | Mack Occupational Health Services Sc | General Practice | N528 Fairland Island, Menominee, MI 49858 | 2009-04-15 |
| 1194901686 | Bonnie Susan Pulkowski | Nurse Practitioner | 1110 10th Ave Ste 101, Menominee, MI 49858 | 2008-01-14 |
| 1740383207 | Troy R Clausen | Dentist | N166 West Dr, Menominee, MI 49858 | 2006-09-07 |
| 1750483095 | George Swift Harris | Dentist | 2012 10th St, Menominee, MI 49858 | 2006-09-05 |
| 1316912397 | John Owens Beldo | Dentist | 2108 22nd Ave, Menominee, MI 49858 | 2006-02-22 |
| Find all providers in zip 49858 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922300714 | Great Lakes Recovery Centers, Inc. | Community/Behavioral Health | 3120 10th Street, Suite 2, Menominee, MI 49858 | 2010-11-30 |
| 1689993800 | Spade's Counseling Agency | Community/Behavioral Health | 621 1st St, Menominee, MI 49858-3229 | 2010-05-27 |
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| Find all providers with the same taxonomy | ||||
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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.