Gabriella R Lake, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

093931 Issued in NY

Practice address

57 W Burnside Ave # B1
Bronx, NY 10453-4038

Phone

(718) 893-8900

NPI assigned

Jul 26, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gabriellalake@tdh.allscriptsdirect.net

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.

• Bronx Medical Practice P.C.

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1356726087
  Medicare reassignment NPD
• Essen Medical Associates, PC

  • Legal Medicine
  • Bronx, NY
  • NPI 1366418709
  Medicare reassignment NPD
• House Call Medical Services of New York, PLLC

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1851345946
  Medicare reassignment NPD
• Shakespeare Operating LLC

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1720634538
  Medicare reassignment NPD
• Essen Medical Associates, PC

  • Podiatrist
  • Bronx, NY
  • NPI 1720799158
  NPD
• Essen Medical Associates,PC

  • Legal Medicine (M.D./D.O.) Physician
  • Jamaica, NY
  • NPI 1700023926
  NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1235616889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 W BURNSIDE AVE # B1",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534038",
            "telephone_number": "718-893-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 W BURNSIDE AVE # B1",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534038",
            "telephone_number": "718-893-8900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "57 W Burnside Ave # B1",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "10453",
            "country_code": "US",
            "telephone_number": "718-893-8900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAKE",
        "first_name": "GABRIELLA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-26",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06155400",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "093931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000000000",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gladys Lajara, MACCCSLP
• Priscilla Lajara
• Deeksha Lakavath, MD
• Codie R Lake, RN
• Dianah Thelma Lake, MD
• Melvina Sharon Lake, LMCSW
• Brando Lydell Lakes, DPT, PT, OCS
• Felicia Lakharam, LPN
• Caitlin Lakis
• Sally Lakis

• Clinical Social Worker in Bronx, NY
• Providers in Bronx, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.