Stephanie Denise Lake, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801109246 Issued in MI

Practice address

3501 Harding St
Dearborn, MI 48124-3731

Phone

(313) 608-5544

NPI assigned

Dec 6, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grow Your Mind Therapy

  • Social Worker
  • Dearborn, MI
  • NPI 1992420251
  Medicare reassignment NPD Authorized official
• Richard Kneip, PH.D., P.C.

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  Medicare reassignment NPD
• Healing Hands Psychology Group

  • Adult Mental Health Clinic/Center
  • Dearborn, MI
  • NPI 1790523231
  NPD Authorized official

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1871008367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23131 MICHIGAN AVE # 1168",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242020",
            "telephone_number": "313-608-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 HARDING ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243731",
            "telephone_number": "313-608-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "STEPHANIE",
        "middle_name": "DENISE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-06",
        "last_updated": "2022-12-14",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801109246",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Gray Lafayette, M.D.
• April Laford
• Emily Laframboise
• Mikael Isiah Lagrand
• Lahc- Leaders Advancing and Helping Communities
• Lakewell Care LLC
• Lakewood Dental Group III
• Lakewood Family Pharmacy LLC
• Jesse David Lalla, LMSW
• Saraann Marie Lalonde

• Social Worker in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.