Provider Demographics
NPI:1679755987
Name:LAKE CITY COUNSELING, LLC
Entity type:Organization
Organization Name:LAKE CITY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:VOECK
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, CSAC
Authorized Official - Phone:608-661-2829
Mailing Address - Street 1:1532 W BROADWAY STE 202
Mailing Address - Street 2:
Mailing Address - City:MONONA
Mailing Address - State:WI
Mailing Address - Zip Code:53713-1828
Mailing Address - Country:US
Mailing Address - Phone:608-661-2829
Mailing Address - Fax:608-661-0907
Practice Address - Street 1:1532 W BROADWAY STE 202
Practice Address - Street 2:
Practice Address - City:MONONA
Practice Address - State:WI
Practice Address - Zip Code:53713-1828
Practice Address - Country:US
Practice Address - Phone:608-661-2829
Practice Address - Fax:608-661-0907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty