Active NPI
Lesa M Lake-Allen, LPC
- Professional Counselor
- West Valley, UT
National Provider Identifier
1275639312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 367729-6004
- Practice address
- 3392 W 3500 S
West Valley, UT 84119-2630 - Phone
- (801) 969-3307
- Fax
- (801) 964-8898
- NPI assigned
- Sep 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 367729-6004 | UT | Primary |
Addresses
Primary practice location
3392 W 3500 S
West Valley, UT 84119-2630
Mailing address
6311 Table Rock Cir
West Jordan, UT 84084-5334
Phone (801) 966-3306
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 367729-6004 | UT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275639312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6311 TABLE ROCK CIR",
"city": "WEST JORDAN",
"state": "UT",
"postal_code": "840845334",
"telephone_number": "801-966-3306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3392 W 3500 S",
"city": "WEST VALLEY",
"state": "UT",
"postal_code": "841192630",
"telephone_number": "801-969-3307",
"fax_number": "801-964-8898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKE-ALLEN",
"first_name": "LESA",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "UT",
"license": "367729-6004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Valley, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.