Organization
LIFESPAN PSYCHOLOGICAL HEALTH COOPERATIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LARSON LMFT (OFFICE ADMINISTRATION)
(262) 223-3082
Entity
Organization
Contact information
Practice address
13035 W BLUEMOUND RD STE 100, BROOKFIELD, WI 53005-8001
(262) 784-1121
(262) 784-9777
Mailing address
13035 W BLUEMOUND RD STE 100, BROOKFIELD, WI 53005-8001
(262) 784-1121
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
02/28/2022
Last updated
02/28/2022
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