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NPI Code Detail

MEDICARE: LYNN D LUEBBEN MS LPC CSAC

MEDICARE:   LYNN D LUEBBEN  MS LPC CSAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor042352WI
2101YA0400XAddiction (Substance Use Disorder) Counselor2247WI
3101YM0800XMental Health Counselor1611125WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548342041
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNN D LUEBBEN MS LPC CSAC
Provider Business Mailing Address
First Line : 723 JUNIPER CT
Second Line :
City : WEST BEND
State : WI
Zip : 53095-4219
Country : US
Telephone Number : 262-334-5424
Fax Number :
Provider Business Practice Location Address
First Line : 10850 W PARK PL
Second Line : SUITE 100
City : MILWAUKEE
State : WI
Zip : 53224-3606
Country : US
Telephone Number : 262-542-3255
Fax Number : 414-359-1021
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2006
Last Update Date : 07/01/2009

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