| Organization Name: | LAKESHORE EDUCATIONAL & COUNSELING SERVICES LLC |
| NPI Number: | 1548355639 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUDI LYNN FISCHER (OWNER) |
| Mailing Address: | 5475 Liberty Ave Vermilion |
| State: | OH US |
| Postal Code: | 440891333 |
| Phone Number: | 4409630402 |
| Fax Number: | 4409634018 |
| NPI Enumeration Date: | 10/04/2006 |
| NPI Last Update Date: | 04/08/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |