Organization
LAKESHORE PROFESSIONAL COUNSELING INC
Active
Other names
Alpha Omega Venture
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNE M HARPER MPS, FT, BCETS, LBSW (CLINIC DIRECTOR)
(906) 864-2590
Entity
Organization
Contact information
Practice address
447 FIRST STREET, MENOMINEE, MI 49858-3307
(906) 864-2590
(906) 864-3058
Mailing address
447 FIRST STREET, MENOMINEE, MI 49858-3307
(906) 864-2590
(906) 864-3058
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1500
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1500
OUTPATIENT MENTAL HEALTH
WI
05
—
42204000
—
WI
Enumeration date
10/24/2006
Last updated
08/22/2020
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