Lake, Eric S

Lake, Eric S is an individual health care provider with primary practice located at 235 Wealthy St Se , Grand Rapids MI 49503-5247. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Counseling. Behavioral Health & Social Service Providers / Counseling is his primary health care specialty. Lake, Eric S can be contacted via phone (616) 840-8000.

Contact Information

Primary practice address
235 Wealthy St Se Grand Rapids MI 49503-5247
Phone: (616) 840-8000
Fax: (616) 840-9771
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 8952 Nebraska
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 121 Nebraska
Behavioral Health & Social Service Providers / Counseling 103TC1900X 6361002966 Michigan

Profile Details

NPI number 1053644377
LBN Legal business name Lake, Eric S
Credentials MA,LLP, CADC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 18th, 2009
Last updated Mar 6th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053644377 NPPES
Nebraska MEDICAID 47082303526

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