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Organization

LIGHTHOUSE CLINIC, LLC

Active
Other names
LHC Aquisitions, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
PAULA TUDOROF (OWNER/MANAGER)
(323) 447-9507
Entity
Organization

Contact information

Practice address
2524 E WEBSTER PL, SUITE 203, MILWAUKEE, WI 53211-4256
(414) 964-9200
(414) 964-4816
Mailing address
2524 E WEBSTER PL STE 203, MILWAUKEE, WI 53211-4257
(414) 964-9200
(414) 964-4816

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
103G00000X
Clinical Neuropsychologist
103T00000X
Psychologist
Primary
1041C0700X
Clinical Social Worker
133V00000X
Registered Dietitian
2084P0800X
Psychiatry Physician
2084P0804X
Child & Adolescent Psychiatry Physician

Other

Enumeration date
10/04/2010
Last updated
03/04/2026
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