Lakeshore Professional Counseling Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1500 Issued in WI

Legal business name

LAKESHORE PROFESSIONAL COUNSELING INC

Practice address

447 First Street
Menominee, MI 49858-3307

Phone

(906) 864-2590

Fax

(906) 864-3058

NPI assigned

Oct 24, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeanne M Harper, MPS, FT, BCETS, LBSWNPI 1235212960

Title

Clinic Director

Phone

(906) 864-2590

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Alpha Omega Venture Former legal business name

Locations

Practitioners 3

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.

• Jeanne M Harper, MPS, FT, BCETS, LBSW

  • Social Worker
  • Menominee, MI
  • NPI 1235212960
  NPD (past) Authorized official
• Joanne Black, MA LLP

  • Clinical Psychologist
  • Menominee, MI
  • NPI 1760426142
  NPD (past)
• Gilbert E Garcia, M.S.W,A.C.S.W, LCSW

  • Clinical Social Worker
  • Menominee, MI
  • NPI 1154436970
  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831272574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 FIRST STREET",
            "city": "MENOMINEE",
            "state": "MI",
            "postal_code": "498583307",
            "telephone_number": "906-864-2590",
            "fax_number": "906-864-3058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 FIRST STREET",
            "city": "MENOMINEE",
            "state": "MI",
            "postal_code": "498583307",
            "telephone_number": "906-864-2590",
            "fax_number": "906-864-3058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE PROFESSIONAL COUNSELING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARPER",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "906-864-2590",
        "authorized_official_credential": "MPS, FT, BCETS, LBSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "1500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42204000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OUTPATIENT MENTAL HEALTH",
            "identifier": "1500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alpha Omega Venture",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Dawn Marie Kowalski, RPH, PHARM D
• Mary Elizabeth Kruse, 201481-30
• Ricky Kurian
• Peter J. Kurtz, OD
• Jessica Lake, RN
• Samantha Jo Larson
• Samuel Joseph Lavalley Jr., D.D.S.
• Barbara Lee Lawatsch, LMT, RN
• Lifesource of North Carolina
• John R Lindt, MA, MDIV, LMFT

• Community/Behavioral Health Agency in Menominee, MI
• Providers in Menominee, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.