Active NPI
Jennifer Lake
- Mental Health Counselor
- Kirkland, WA
National Provider Identifier
1164079968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH60971860
- Practice address
- 11335 NE 122ND Way Ste 105
Kirkland, WA 98034-6933 - Phone
- (662) 571-2025
- NPI assigned
- Aug 26, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LH60971860 | WA | Primary |
Addresses
Primary practice location
11335 NE 122ND Way Ste 105
Kirkland, WA 98034-6933
Mailing address
1286 Cross Creek Blvd
Hernando, MS 38632
Phone (662) 571-2025
Other practice location 1
1286 Cross Creek Blvd
Hernando, MS 38632
Phone (662) 571-2025
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 |
|---|---|---|---|
| LH60971860 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carebridgetn, LLC | Current | Accepting new patients | |
| Better Choice Home Care, LLC | Current | Accepting new patients |
Organizations & group practices 2
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.
-
- Adult Companion
- Southaven, MS
- NPI 1962191544
-
- In Home Supportive Care Agency
- Memphis, TN
- NPI 1174366280
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566777600000",
"number": "1164079968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1286 CROSS CREEK BLVD",
"city": "HERNANDO",
"state": "MS",
"postal_code": "38632",
"telephone_number": "662-571-2025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11335 NE 122ND WAY STE 105",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980346933",
"telephone_number": "662-571-2025"
}
],
"practiceLocations": [
{
"address_1": "1286 CROSS CREEK BLVD",
"address_purpose": "LOCATION",
"city": "Hernando",
"state": "MS",
"postal_code": "38632",
"country_code": "US",
"telephone_number": "662-571-2025",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LAKE",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-26",
"last_updated": "2019-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH60971860",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirkland, WA
- Lake Washington Family Chiropractic, PLLC
- Lake Washington Midwives
- Lake Washington Physical Therapy LLC
- Lake Washington Private Medicine Inc
- Lake Washington Technical College Dental Clinic
- Brianna Deshai Lakes, PT, DPT
- Lakeshore Clinic PLLC
- Lakeside Recovery Centers Inc
- Lakeside Recovery Centers Inc
- Lakeview of Kirkland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.