Organization Active NPI

Lake Family Counseling, LLC

  • Pastoral Counselor
  • Fort Myers, FL
National Provider Identifier
1174499735
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pastoral CounselorTaxonomy code 101YP1600X
Legal business name
LAKE FAMILY COUNSELING, LLC
Practice address
4461 Buckingham Rd
Fort Myers, FL 33905-7221
Phone
(863) 843-9277
NPI assigned
Oct 13, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. James Andrew Lake, LCMFT, SCC-CNPI 1356217913
Title
Owner
Phone
(863) 843-9277

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP1600X Primary

Addresses

Primary practice location

4461 Buckingham Rd
Fort Myers, FL 33905-7221

Mailing address

4461 Buckingham Rd
Fort Myers, FL 33905-7221
Phone (863) 843-9277

National Provider Directory

National Provider Directory

Locations

4461 Buckingham Rd
Fort Myers, FL 33905
Phone (330) 333-1909

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1760313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1174499735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4461 BUCKINGHAM RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057221",
            "telephone_number": "863-843-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4461 BUCKINGHAM RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057221",
            "telephone_number": "863-843-9277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE FAMILY COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-13",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "LAKE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-843-9277",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LCMFT, SCC-C"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.