Active NPI
Melissa Lake, L.P.C.
- Professional Counselor
- Indiana, PA
National Provider Identifier
1881047256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC009052
- Practice address
- 647 Philadelphia St
Suite 403
Indiana, PA 15701-3923 - Phone
- (724) 427-5453
- NPI assigned
- Jul 20, 2016
- Last updated
- Jul 20, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC009052 | PA | Primary |
Addresses
Primary practice location
647 Philadelphia St
Suite 403
Indiana, PA 15701-3923
Mailing address
647 Philadelphia St
Suite 403
Indiana, PA 15701-3923
Phone (724) 427-5453
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 2, 2026 through Mar 2, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC009052 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468972800000",
"number": "1881047256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "647 PHILADELPHIA ST",
"address_2": "SUITE 403",
"city": "INDIANA",
"state": "PA",
"postal_code": "157013923",
"telephone_number": "724-427-5453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "647 PHILADELPHIA ST",
"address_2": "SUITE 403",
"city": "INDIANA",
"state": "PA",
"postal_code": "157013923",
"telephone_number": "724-427-5453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKE",
"first_name": "MELISSA",
"credential": "L.P.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-20",
"last_updated": "2016-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC009052",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indiana, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.