Libby Lake Counseling LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

LIBBY LAKE COUNSELING LLC

Practice address

2410 Grape Rd Ste 1
Mishawaka, IN 46545-3015

Phone

(574) 298-7733

NPI assigned

Nov 5, 2024

Organization subpart

No

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

Authorized official

Name

Elizabeth Lake, LMHCNPI 1801619119

Title

Licensed Mental Health Counselor

Phone

(574) 298-7733

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Practitioners 1

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

• Elizabeth Ann Lake, LMHC

  • Mental Health Counselor
  • Mishawaka, IN
  • NPI 1801619119

  Professional

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1205659554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 GRAPE RD STE 1",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453015",
            "telephone_number": "574-298-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 GRAPE RD STE 1",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453015",
            "telephone_number": "574-298-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBBY LAKE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "LAKE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "LICENSED MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "574-298-7733",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Sue Lenfestey, MSN, APRN, CNS
• Erin K Leonard, PHD, MSW, LCSW
• Zachary Joe Maranar Leshen, M.D.
• Izaak J Lewis
• Anita Li, MD
• Emma Grace Lichtenbarger
• Life in Balance LLC
• Lifetime Pharmacy, LLC
• Lifetime Pharmacy, LLC
• Carianne Nicole Lilly, DPM

• Professional Counselor in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Professional Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.