Nicole Lake

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5025 Issued in NH

Practice address

67 Corporate Dr
Portsmouth, NH 03801-2847

Phone

(603) 610-8050

NPI assigned

Mar 25, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NH

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

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wentworth Douglass Physician CorporationGroup PAC ID 5496749848, 429 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wentworth Douglass Physician Corporation

  • Magnetic Resonance Imaging Radiologic Technologist
  • Dover, NH
  • NPI 1447352430
  Medicare reassignment Care Compare group NPD
• Wentworth Douglass Physician Corporation

  • Diagnostic Radiology Physician
  • Somersworth, NH
  • NPI 1295326494
  NPD
• Wentworth Douglass Physician Corporation

  • Addiction (Substance Use Disorder) Counselor
  • Dover, NH
  • NPI 1710504683
  NPD

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1285211300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 CORPORATE DR",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038012847",
            "telephone_number": "603-610-8050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3250 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Juneau",
            "state": "AK",
            "postal_code": "998017808",
            "country_code": "US",
            "telephone_number": "907-796-8690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAKE",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-25",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "5025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.bartletthospital.org",
            "affiliation": "N",
            "address_1": "3250 Hospital Dr",
            "city": "Juneau",
            "state": "AK",
            "country_code": "US",
            "postal_code": "998017808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Linda Ann Laflamme, APRN
• Charity Rae Lafrance, LCMHC
• Richard Lafrenaye, MSW
• Susan Rivchun Lager, LICSW
• Kenneth Thomas Lajoie, DO
• Rebecca Laliberte, PA-C
• Angela P Lambert, ND, LAC
• Brianna Boyle Lambert
• Catherine Lamond, PSY, D.
• Francois C. Lamothe, DDS

• Clinical Social Worker in Portsmouth, NH
• Providers in Portsmouth, NH by specialty
• Clinical Social Worker in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.
• 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.

Verify at the official NPI Registry.