Alexis Lake, MSS, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW019825 Issued in PA

Practice address

931 Harrisburg Ave Ste 9
Lancaster, PA 17603-2652

Phone

(717) 544-9051

Fax

(717) 735-9234

NPI assigned

Nov 1, 2009

Last updated

Oct 15, 2019By the provider in NPPES

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 names 1

• Alexis Lake Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lake Therapy LLC

  • Community/Behavioral Health Agency
  • Lititz, PA
  • NPI 1497105233
  NPD (past) Authorized official

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

{
    "created_epoch": "1257033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1316273055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 HARRISBURG AVE STE 9",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176032652",
            "telephone_number": "717-544-9051",
            "fax_number": "717-735-9234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 HARRISBURG AVE STE 9",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176032652",
            "telephone_number": "717-544-9051",
            "fax_number": "717-735-9234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "ALEXIS",
        "credential": "MSS, LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-01",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "SW127241",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW019825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "LAKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Georges Lahoud, PHARMD, PHD
• Kelly A Laino, CRNP
• Amanda Kerstin Laird
• Kenneth William Laird, MD
• Adam C Lake, MD
• Mehul J Lalani, MD
• Andrew Lally, PT, DPT
• Nicole A Lam, LPC, CAADC
• April McCall Lamb, MA, LMFT
• Anita Lambert, R.PH.

• Clinical Social Worker in Lancaster, PA
• Providers in Lancaster, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.