Active NPI
Kirsten Lake, LMSW
- Social Worker
- Hunt Valley, MD
National Provider Identifier
1104640283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 32490
- Practice address
- 1350 McCormick Rd Suite 600,
Executive Suite III
Hunt Valley, MD 21031 - Phone
- (443) 708-5856
- NPI assigned
- Nov 14, 2024
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 32490 | MD | Primary |
Addresses
Primary practice location
1350 McCormick Rd Suite 600,
Executive Suite III
Hunt Valley, MD 21031
Mailing address
1350 McCormick Rd Suite 600,
Executive Suite III
Hunt Valley, MD 21031
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 |
|---|---|---|---|
| 32490 | MD | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731542400000",
"number": "1104640283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1350 MCCORMICK RD SUITE 600,",
"address_2": "EXECUTIVE SUITE III",
"city": "HUNT VALLEY",
"state": "MD",
"postal_code": "21031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 MCCORMICK RD SUITE 600,",
"address_2": "EXECUTIVE SUITE III",
"city": "HUNT VALLEY",
"state": "MD",
"postal_code": "21031",
"telephone_number": "443-708-5856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKE",
"first_name": "KIRSTEN",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-14",
"last_updated": "2024-11-14",
"certification_date": "2024-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "32490",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hunt Valley, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.