Provider Demographics
NPI:1639463680
Name:LH COUNSELING
Entity Type:Organization
Organization Name:LH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LILITA
Authorized Official - Middle Name:V
Authorized Official - Last Name:HARDES
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:414-640-3393
Mailing Address - Street 1:13500 W CAPITOL DR
Mailing Address - Street 2:102
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-2444
Mailing Address - Country:US
Mailing Address - Phone:414-640-3393
Mailing Address - Fax:262-257-0602
Practice Address - Street 1:13500 W CAPITOL DR
Practice Address - Street 2:102
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-2444
Practice Address - Country:US
Practice Address - Phone:414-640-3393
Practice Address - Fax:262-257-0602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1807-123251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39537700Medicaid