Leonard Lake

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

82576 Issued in TX

Practice address

5424 Rufe Snow Dr Ste 200
North Richland Hills, TX 76180-6685

Phone

(817) 993-9814

NPI assigned

Oct 17, 2022

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

Electronic endpoints 1

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": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1861118416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5424 RUFE SNOW DR STE 200",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761806685",
            "telephone_number": "817-993-9814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5424 RUFE SNOW DR STE 200",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761806685",
            "telephone_number": "817-993-9814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "LEONARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "82576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "5424 Rufe Snow Dr Ste 200",
            "city": "North Richland Hills",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761806685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Professional Counselor in North Richland Hills, TX
• Providers in North Richland Hills, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.