Provider Demographics
NPI:1942067459
Name:LAKEVIEW COUNSELING
Entity Type:Organization
Organization Name:LAKEVIEW COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:CSW-PIP, QMHP
Authorized Official - Phone:605-661-9076
Mailing Address - Street 1:103 CURLIE ST
Mailing Address - Street 2:
Mailing Address - City:YANKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57078-4727
Mailing Address - Country:US
Mailing Address - Phone:605-661-9076
Mailing Address - Fax:
Practice Address - Street 1:103 CURLIE ST
Practice Address - Street 2:
Practice Address - City:YANKTON
Practice Address - State:SD
Practice Address - Zip Code:57078-4727
Practice Address - Country:US
Practice Address - Phone:605-661-9076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)