Emily Elizabeth Lake, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C5190 Issued in OR

Practice address

5741 NE Glisan St Ste 2
Portland, OR 97213-3793

Phone

(360) 608-5360

NPI assigned

Nov 11, 2015

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Willamette Health & Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
  • NPI 1093140188
  NPD

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

{
    "created_epoch": "1447200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1912370032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5741 NE GLISAN ST STE 2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972133793",
            "telephone_number": "360-608-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5741 NE GLISAN ST STE 2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972133793",
            "telephone_number": "360-608-5360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 NE Multnomah St Ste 275",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972324103",
            "country_code": "US",
            "telephone_number": "503-729-1380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAKE",
        "first_name": "EMILY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-11",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG60613583",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C5190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hussain M. Lakdawalla, M.D.
• Lake Oswego Natural Health
• Andrew Lake
• Dakota Micheal Lake, LCSW
• Dana Michal Lake
• Rochelle Jeaness Lake, MA, QMHP
• Violet Lawther Lakeland, FPMHNP-BC
• Lakeside Serenity Psychiatry, LLC
• Lakeview Neurophysiology
• Paul Conrad Lakin, MD

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.