Cynthia Susan Lake

Primary specialty

Social WorkerTaxonomy code 104100000X

License

CSW003225 Issued in GA

Practice address

3421 Mike Padgett Hwy
Augusta, GA 30906-3815

Phone

(706) 432-4872

NPI assigned

Dec 6, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1255315842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3813 PINE KNOLL CT",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309072820",
            "telephone_number": "706-868-1547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 MIKE PADGETT HWY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309063815",
            "telephone_number": "706-432-4872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "CYNTHIA",
        "middle_name": "SUSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "CSW003225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000606317B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marylou Lacomb-Davis, CPNP-PC
• Amber Ladak, PHARMD
• Derek Aaron Lafont, PA-C
• Lawrence James Lahatte, M.D.
• Brenton Carter Lake, PHARM.D.
• Venkata Mohan Raju Lakkimsetty, MD
• Sunil K Lal, M.D.
• Raheem Lalani, DO
• Salima Lalani, MD
• Aubrey Anna Lamar, PT, DPT

• Social Worker in Augusta, GA
• Providers in Augusta, GA by specialty
• Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; 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.