Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lakeside Family Therapy Services Ltd

Organization Addiction (Substance Use Disorder) Counselor · NPI 1407998719

Lakeside Family Therapy Services Ltd is an Addiction (Substance Use Disorder) Counselor in Racine, Wisconsin. Registered with an NPI since 2007.

In the registry since
2007
Specialties on file
4
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4810 Northwestern Ave
Racine, WI 53406
Phone: (262) 637-9984
Fax: (262) 637-9995
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Clinic/Center (Including Community Mental Health Center) (primary) Taxonomy 261QM0801X
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X
Mental Health Counselor Taxonomy 101YM0800X
Multi-Specialty Clinic/Center Taxonomy 261QM1300X

Record details

NPI number1407998719
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jacqueline McRae — President · (262) 637-9984
NPI enumeratedFebruary 13, 2007
Last updated in NPPESAugust 6, 2021
Certification dateAugust 6, 2021
Mailing address4810 Northwestern Ave, Racine, WI 53406-1504

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