LAKESIDE FAMILY THERAPY SERVICES LTD
NPI 1407998719
Clinic/Center - Mental Health (Including Community Mental Health Center) in Racine, WI
About Lakeside Family Therapy Services Ltd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKESIDE FAMILY THERAPY SERVICES LTD (NPI 1407998719) is a healthcare organization registered as a mental health (including community mental health center) in Racine, Wisconsin and active in the NPI registry since February 2007. The organization lists Jacqueline V Mcrae, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lakeside Family Therapy Services Ltd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Lakeside Family Therapy Services Ltd, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Lakeside Family Therapy Services Ltd's NPI number?
The NPI number for Lakeside Family Therapy Services Ltd is 1407998719. It was assigned to this organization in the NPPES registry on February 13, 2007.
Where is Lakeside Family Therapy Services Ltd located?
Lakeside Family Therapy Services Ltd is located at 4810 Northwestern Ave, Racine, WI 53406. The listed phone number is (262) 637-9984.
What is Lakeside Family Therapy Services Ltd's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.
Is Lakeside Family Therapy Services Ltd enrolled in Medicare?
Yes. Lakeside Family Therapy Services Ltd is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Lakeside Family Therapy Services Ltd?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Lakeside Family Therapy Services Ltd. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (3) and Nurse Practitioner (1). Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Lakeside Family Therapy Services Ltd accept?
Health plans from Anthem Blue Cross and Blue Shield and CareSource (Common Ground Healthcare) list Lakeside Family Therapy Services Ltd as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Lakeside Family Therapy Services Ltd was last updated on August 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Lakeside Family Therapy Services Ltd · NPI 1407998719
Mental Health (Including Community Mental Health Center) organization in Racine, Wisconsin. Organization record, active in the CMS NPPES registry since February 13, 2007.
## Identity
- **NPI:** 1407998719 (Entity type: Organization)
- **Enumerated:** February 13, 2007
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Organization subpart:** No
- **Authorized official:** Jacqueline Mcrae, PRESIDENT
## Practice location
- **Address:** 4810 NORTHWESTERN AVE, Racine, WI 53406
- **Phone:** (262) 637-9984 · **Fax:** (262) 637-9995
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (3), Nurse Practitioner (1); 2 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 6, 2021
- **Other identifiers:** Medicaid 42120700 (WI)
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Source: [NPI Profile](https://npiprofile.com/npi/1407998719) · Data from the CMS NPPES public registry.