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General NPI Number Information
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NPI Number | 1326928342
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Entity Type | Organization
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Legal Business Name | LITTLE LIGHTHOUSE COUNSELING
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 830 N 109TH ST STE 1
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City | WAUWATOSA
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State | WI
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Zip | 53226-3754
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Country | US
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Telephone | 414-215-0427
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Fax |
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Provider Business Mailing Address
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Address Line | 830 N 109TH ST STE 1
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City | WAUWATOSA
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State | WI
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Zip | 53226-3754
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | THERAPIST IN TRAINING
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Name | MCKENNA LUCARELI
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Credential |
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Telephone | 262-488-4834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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