Organization
LANDERS PSYCHOTHERAPY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE LANDERS LCSW, CSAC (OWNER)
(262) 408-0588
Entity
Organization
Contact information
Practice address
15460 W CAPITOL DR STE 222, BROOKFIELD, WI 53005-2632
(262) 408-0588
(262) 599-8119
Mailing address
15460 W CAPITOL DR STE 222, BROOKFIELD, WI 53005-2632
(262) 408-0588
(262) 599-8119
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6864123
WI
1041C0700X
Clinical Social Worker
Primary
6864123
WI
Other
Enumeration date
03/31/2015
Last updated
05/16/2020
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