Provider Demographics
NPI:1609626522
Name:LAKELAND COUNSELING AND ASSESSMENT, LLC
Entity Type:Organization
Organization Name:LAKELAND COUNSELING AND ASSESSMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BJORN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:608-218-4338
Mailing Address - Street 1:518 N FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-3640
Mailing Address - Country:US
Mailing Address - Phone:608-218-4338
Mailing Address - Fax:
Practice Address - Street 1:518 N FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3640
Practice Address - Country:US
Practice Address - Phone:608-218-4338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)