Active NPI
Jacqueline Lake
- Professional Counselor
- Plymouth, MA
National Provider Identifier
1124775598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 900 Ship Pond Rd
Plymouth, MA 02360-1849 - Phone
- (508) 224-8041
- NPI assigned
- Mar 7, 2022
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
900 Ship Pond Rd
Plymouth, MA 02360-1849
Mailing address
31 Copper Lantern LN
Carver, MA 02330-1763
Phone (781) 760-3730
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646611200000",
"number": "1124775598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 COPPER LANTERN LN",
"city": "CARVER",
"state": "MA",
"postal_code": "023301763",
"telephone_number": "781-760-3730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 SHIP POND RD",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "023601849",
"telephone_number": "508-224-8041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKE",
"first_name": "JACQUELINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-07",
"last_updated": "2022-03-07",
"certification_date": "2022-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.