Village Lake LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

VILLAGE LAKE LLC

Doing business as

Village Lake Counseling

Practice address

345 Riverview St. #730
Wichita
KS, KS 67203

Phone

(316) 395-2886

NPI assigned

May 15, 2024

Organization subpart

No

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

Authorized official

Name

Anaidy G Claudio Rosa, LSCSW, LCACNPI 1629472691

Title

Therapist

Phone

(316) 284-7730

Specialties & licenses 1

Addresses

Other names 1

• Village Lake Counseling Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anaidy Claudio Rosa, LSCSW, LCAC

  • Clinical Social Worker
  • Wichita, KS
  • NPI 1629472691
  NPD Authorized official

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785542400000",
    "number": "1326897067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 E HAVEN DR",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670377041",
            "telephone_number": "316-284-7730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 RIVERVIEW ST. #730",
            "address_2": "WICHITA",
            "city": "KS",
            "state": "KS",
            "postal_code": "67203",
            "telephone_number": "316-395-2886"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3701 E Haven Dr",
            "address_purpose": "LOCATION",
            "city": "Derby",
            "state": "KS",
            "postal_code": "670377041",
            "country_code": "US",
            "telephone_number": "316-284-7730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VILLAGE LAKE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-15",
        "last_updated": "2026-08-01",
        "certification_date": "2026-08-01",
        "status": "A",
        "authorized_official_last_name": "CLAUDIO ROSA",
        "authorized_official_first_name": "ANAIDY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "316-284-7730",
        "authorized_official_credential": "LSCSW, LCAC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Lake Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Village Lake Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2026; 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.