Active NPI
Alexandria Lake, LMHC
- Clinical Psychologist
- New York, NY
National Provider Identifier
1093384554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 011425-01
- Practice address
- 205 E 95TH St Apt 32E
New York, NY 10128-4075 - Phone
- (917) 454-4656
- NPI assigned
- Jun 21, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 011425-01 | NY | Primary |
Addresses
Primary practice location
205 E 95TH St Apt 32E
New York, NY 10128-4075
Mailing address
205 E 95TH St Apt 32E
New York, NY 10128-4075
Phone (917) 454-4656
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011425-01 | NY | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Current | Accepting new patients |
Interoperability endpoints
- alexandrialake@tdh.allscriptsdirect.net
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Lewisville, TX
- NPI 1245403567
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624233600000",
"number": "1093384554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 E 95TH ST APT 32E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101284075",
"telephone_number": "917-454-4656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 E 95TH ST APT 32E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101284075",
"telephone_number": "917-454-4656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKE",
"first_name": "ALEXANDRIA",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-21",
"last_updated": "2021-06-21",
"certification_date": "2021-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "011425-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.