Active NPI
The Lakes Behavioral Health, LLC
- Substance Abuse Rehabilitation Facility
- Lakeland, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Abuse Rehabilitation Facility
- Legal business name
- THE LAKES BEHAVIORAL HEALTH, LLC
- Practice address
- 420 W Magnolia St
Lakeland, FL 33815-0001 - Phone
- (225) 936-5954
- NPI assigned
- Mar 5, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cory Bickham, LCDC
- Title
- Executive Director
- Phone
- (225) 936-5954
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | Primary |
Addresses
Primary practice location
420 W Magnolia St
Lakeland, FL 33815-0001
Mailing address
420 W Magnolia St
Lakeland, FL 33815-0001
Phone (225) 936-5954
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2341998 | The Lakes Behavioral Health LLC | Certificate of waiver | Apr 10, 2028 |
National Provider Directory
National Provider DirectoryLocations
420 W Magnolia St
Lakeland, FL 33815
Phone (225) 936-5954
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
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- Manor, TX
- NPI 1518580570
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1772668800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1772668800000",
"number": "1245186154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 W MAGNOLIA ST",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338150001",
"telephone_number": "225-936-5954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 W MAGNOLIA ST",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338150001",
"telephone_number": "225-936-5954"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE LAKES BEHAVIORAL HEALTH, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-03-05",
"last_updated": "2026-03-05",
"certification_date": "2026-03-05",
"status": "A",
"authorized_official_last_name": "BICKHAM",
"authorized_official_first_name": "CORY",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "225-936-5954",
"authorized_official_credential": "LCDC"
},
"taxonomies": [
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.