Individual provider Active NPI

Lisa Miles, LPC-IT

  • Professional Counselor
  • Pewaukee, WI
National Provider Identifier
1083459697
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
12640-125 Issued in WI
Practice address
353 Forest Grove Dr Ste 100
Pewaukee, WI 53072-3765
Phone
(262) 470-9131
Fax
(262) 691-2972
NPI assigned
Jun 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 12640-125 WI Primary

Addresses

Primary practice location

353 Forest Grove Dr Ste 100
Pewaukee, WI 53072-3765

Mailing address

353 Forest Grove Dr Ste 100
Pewaukee, WI 53072-3765
Phone (262) 470-9131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7986-226WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Counseling Services, LLC Professional CurrentSince Sep 15, 2024 Accepting new patients

Locations

353 Forest Grove Dr
Ste 100
Pewaukee, WI 53072
Phone (262) 393-1660

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1083459697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 FOREST GROVE DR STE 100",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530723765",
            "telephone_number": "262-470-9131",
            "fax_number": "262-691-2972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 FOREST GROVE DR STE 100",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530723765",
            "telephone_number": "262-470-9131",
            "fax_number": "262-691-2972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "LISA",
        "credential": "LPC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-26",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "12640-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pewaukee, WI

Sources for this page

Verify at the official NPI Registry.