NPIMap

Organization Active NPI

Lighthouse Counseling Services, LLC

  • Professional Counselor
  • Pewaukee, WI
National Provider Identifier
1821799370
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
LIGHTHOUSE COUNSELING SERVICES, LLC
Practice address
353 Forest Grove Dr Ste 100
Pewaukee, WI 53072-3765
Phone
(262) 719-9470
Fax
(262) 691-2972
NPI assigned
Mar 13, 2023
Last updated
Sep 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Authorized official

Name
Jefferson D Ferguson, MSNPI 1164533147
Title
Therapist/Co-Owner
Phone
(262) 719-9470

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X 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) 719-9470

Other identifiers 1

IdentifierTypeStateIssuer
40965300MedicaidWI

Other names 1

  • Jefferson Ferguson, SC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250128000533 WI Part B Supplier - Clinic/Group Practice 1456880020 Receives reassigned benefits from 6 practitioners
Practice locations: Pewaukee, WI

National Provider Directory

National Provider Directory

Locations

325 Forest Grove Dr
Ste 201
Pewaukee, WI 53072
Phone (262) 691-2980

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

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725926400000",
    "number": "1821799370",
    "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": "262-719-9470",
            "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": "262-719-9470",
            "fax_number": "262-691-2972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-13",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "JEFFERSON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "THERAPIST/CO-OWNER",
        "authorized_official_telephone_number": "262-719-9470",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40965300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jefferson Ferguson, SC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Jefferson Ferguson, SC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Pewaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.