Individual provider Active NPI

Nancy Birgitta Lake, LISW, BCD

  • Clinical Social Worker
  • Iowa City, IA
National Provider Identifier
1942270194
Registry record updated Sep 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
01439 Issued in IA
Practice address
332 S Linn St
Suite 17
Iowa City, IA 52240-1608
Phone
(319) 338-5181
NPI assigned
Jan 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 01439 IA Primary

Addresses

Primary practice location

332 S Linn St
Suite 17
Iowa City, IA 52240-1608

Mailing address

332 S Linn St
Suite 17
Iowa City, IA 52240-1608
Phone (319) 338-5181

Other names 1

  • N. Birgitta Lake Professional name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
01439IAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
East Iowa Psychology Group PC Past Accepting new patients
Anne M. Green, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252886400000",
    "number": "1942270194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 S LINN ST",
            "address_2": "SUITE 17",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522401608",
            "telephone_number": "319-338-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 S LINN ST",
            "address_2": "SUITE 17",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522401608",
            "telephone_number": "319-338-5181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "NANCY",
        "middle_name": "BIRGITTA",
        "credential": "LISW, BCD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2009-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "01439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N.",
            "last_name": "LAKE",
            "middle_name": "BIRGITTA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; 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.