Lakefront Wellness Center, Sc

NPI #1316024847 in Pewaukee, Wisconsin

Provider Information

NPI Number: 1316024847
Entity Type: Organization
Organization Name: Lakefront Wellness Center, Sc
Primary Specialty: Psychologist - Clinical
Enumeration Date: Nov 1, 2006
Last Updated: Aug 27, 2013

Practice Location

Address: 161 W WISCONSIN AVE STE 2B
City: Pewaukee
State: Wisconsin
ZIP Code: 53072-3468
Phone: (262) 695-8857

Authorized Official

Name: DR. BETH A. JOHNSON, PSY.D.
Title: DIRECTOR
Phone: (262) 695-8857

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Psychologist	103T00000X
Social Worker - Clinical — Clinical	1041C0700X
Marriage & Family Therapist	106H00000X
Psychologist - Clinical — Clinical	103TC0700X	Primary

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