Hanna Bakken, MA

Individual provider Active NPI Professional Counselor · Pewaukee, WI

NPI 1760193494 · NPPES record last updated Sep 10, 2024

Key facts

NPI
1760193494
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
10171-125 (WI)
Practice address
353 Forest Grove Dr Ste 100
Pewaukee, WI 53072-3765
Phone
(608) 778-7190
NPI assigned
Dec 13, 2022
Sex
Female
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lighthouse Counseling Services LLC (3 clinicians)

Practice addresses (Care Compare)

353 Forest Grove Dr
Suite 100
Pewaukee, WI 53072-3765
Phone (262) 393-1660

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20250204002171 WI Practitioner - Mental Health Counselor 4981134152 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
10171-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Counseling Services, LLC Professional Current
since Jan 21, 2025
Accepting new patients

Locations

325 Forest Grove Dr
Ste 201
Pewaukee, WI 53072
Phone (262) 271-5511

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor
Group: 193400000X SINGLE SPECIALTY GROUP
101YP2500X 10171-125 WI Yes

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 (608) 778-7190

Other providers in Pewaukee, WI

All providers in Pewaukee, WI · Professional Counselor in Wisconsin

Sources for this page

Verify at the official NPI Registry.