Geoffrey Allyn Lake, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

S.1200724 Issued in OH

Practice address

22001 Fairmount Blvd
Shaker Heights, OH 44118-4819

Phone

(216) 932-6152

NPI assigned

Aug 29, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

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.

• Thrive Counseling LLC

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  OH

  Medicare reassignment NPD

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1982952503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22001 FAIRMOUNT BLVD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441184819",
            "telephone_number": "216-932-6152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22001 FAIRMOUNT BLVD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441184819",
            "telephone_number": "216-932-6152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "GEOFFREY",
        "middle_name": "ALLYN",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1200724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse Kurn, LPC
• Mandy Devra Kwait, LISW-S
• Jacques Kyanza Kyagilo Sr.
• Angela O Kyei, M.D.
• She'Ahra Rischai Kyle
• Jordyn Lally
• Joanna Kristine Lane, LSW
• Lauri Anne Laribee, LPCC-S
• Alyssa Latona
• Katherine Lavik, PHD

• Clinical Social Worker in Shaker Heights, OH
• Providers in Shaker Heights, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.