Landers Psychotherapy Services LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6864123 Issued in WI

Legal business name

LANDERS PSYCHOTHERAPY SERVICES LLC

Practice address

15460 W Capitol Dr Ste 222
Brookfield, WI 53005-2632

Phone

(262) 408-0588

Fax

(262) 599-8119

NPI assigned

Mar 31, 2015

Organization subpart

No

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

Authorized official

Name

Jackie Landers, LCSW, CSAC

Title

Owner

Phone

(262) 408-0588

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Lee Landers, MSW LCSW CSAC

  • Clinical Social Worker
  • Elm Grove, WI
  • NPI 1043303787
  Medicare reassignment

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589587200000",
    "number": "1851786529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15460 W CAPITOL DR STE 222",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530052632",
            "telephone_number": "262-408-0588",
            "fax_number": "262-599-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15460 W CAPITOL DR STE 222",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530052632",
            "telephone_number": "262-408-0588",
            "fax_number": "262-599-8119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANDERS PSYCHOTHERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-31",
        "last_updated": "2020-05-16",
        "certification_date": "2020-05-16",
        "status": "A",
        "authorized_official_last_name": "LANDERS",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-408-0588",
        "authorized_official_credential": "LCSW, CSAC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "6864123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "6864123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia Elyse Lally
• Rebecca Lambert, MD
• Ashanti Lambrecht
• Mary Lambright
• Malinee Lamont
• Landgraf Chiropractic, LLC
• Benjamin Landgraf
• Patricia Hope Landgraf, D.C.
• Andrea Marie Lange, D.C.
• Jessica Lange, M.A., LPC

• Clinical Social Worker in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2020; 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.