Active NPI
Alicia Danielle Lake
- Clinical Social Worker
- Lincoln, NE
National Provider Identifier
1487349726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2450
- Practice address
- 420 Victory Park Dr
Lincoln, NE 68510-2484 - Phone
- (402) 486-3802
- NPI assigned
- Apr 11, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2450 | Primary |
Addresses
Primary practice location
420 Victory Park Dr
Lincoln, NE 68510-2484
Mailing address
420 Victory Park Dr
Lincoln, NE 68510-2484
Phone (402) 486-3802
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729814400000",
"number": "1487349726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 VICTORY PARK DR",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685102484",
"telephone_number": "402-486-3802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 VICTORY PARK DR",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685102484",
"telephone_number": "402-486-3802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKE",
"first_name": "ALICIA",
"middle_name": "DANIELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-11",
"last_updated": "2024-10-25",
"certification_date": "2024-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": "2450",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.