Dakota Micheal Lake, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

L11777 Issued in OR

Practice address

5441 S Macadam Ave
Portland, OR 97239-6106

Phone

(971) 415-5755

Fax

(971) 415-5855

NPI assigned

Oct 30, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1698624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1407628845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 N ALBINA AVE APT 406",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972172671",
            "telephone_number": "616-821-6584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5441 S MACADAM AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396106",
            "telephone_number": "971-415-5755",
            "fax_number": "971-415-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "DAKOTA",
        "middle_name": "MICHEAL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-30",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "L11777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie C Lakaemper, NP
• Jason Thomas Lakamp
• Hussain M. Lakdawalla, M.D.
• Lake Oswego Natural Health
• Andrew Lake
• Dana Michal Lake
• Emily Elizabeth Lake, MA
• Rochelle Jeaness Lake, MA, QMHP
• Violet Lawther Lakeland, FPMHNP-BC
• Lakeside Serenity Psychiatry, LLC

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; 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.