=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215401468
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LK ANDERSON CONSULTING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/21/2019
-----------------------------------------------------
Last Update Date | 07/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 325 N COMMERCIAL ST
-----------------------------------------------------
City | NEENAH
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54956-2665
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 920-725-1230
-----------------------------------------------------
Fax | 920-215-6164
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 325 N COMMERCIAL ST
-----------------------------------------------------
City | NEENAH
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54956-2665
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 920-725-1230
-----------------------------------------------------
Fax | 920-215-6164
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | LISA K ANDERSON
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 920-725-1230
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------