Provider Demographics
NPI:1326928342
Name:LITTLE LIGHTHOUSE COUNSELING
Entity type:Organization
Organization Name:LITTLE LIGHTHOUSE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST IN TRAINING
Authorized Official - Prefix:
Authorized Official - First Name:MCKENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCARELI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-488-4834
Mailing Address - Street 1:830 N 109TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3754
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:830 N 109TH ST STE 1
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-3754
Practice Address - Country:US
Practice Address - Phone:414-215-0427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty