Individual provider Active NPI

Laverne Lake

  • Mental Health Counselor
  • West Palm Beach, FL
National Provider Identifier
1477790772
Registry record updated Apr 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1639 Forum PL
Suite 7
West Palm Beach, FL 33401-2330
Phone
(561) 712-8821
NPI assigned
Jan 8, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Marriage & Family Therapist 106H00000X

Addresses

Primary practice location

1639 Forum PL
Suite 7
West Palm Beach, FL 33401-2330

Mailing address

1639 Forum PL
Suite 7
West Palm Beach, FL 33401-2330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20241015004141 FL Practitioner - Mental Health Counselor 3779015763 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Multilingual Psychotherapy Centers, Inc. CurrentSince Oct 4, 2024 Accepting new patients

Locations

1639 Forum Pl
Ste 7
West Palm Beach, FL 33401

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398816000000",
    "number": "1477790772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1639 FORUM PL",
            "address_2": "SUITE 7",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334012330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1639 FORUM PL",
            "address_2": "SUITE 7",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334012330",
            "telephone_number": "561-712-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "LAVERNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-08",
        "last_updated": "2014-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.