Lake Country Counseling Service

NPI #1831328533 in Pewaukee, Wisconsin

Provider Information

NPI Number
1831328533
Entity Type
Organization
Organization Name
Lake Country Counseling Service
Primary Specialty
Counselor - Professional
Enumeration Date
Jul 2, 2009
Last Updated
Jul 2, 2009

Practice Location

Address
325 FOREST GROVE DR
Address 2
STE. 201
ZIP Code
53072-3793
Phone
(262) 719-9470

Authorized Official

Name
MR. JEFFERSON DAVID FERGUSON, MS, LPC
Title
OWNER/CHILD AND FAMILY THERAPIST
Phone
(262) 691-2982

Specialties & Taxonomy Codes

Specialty
Counselor - ProfessionalProfessional

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