Lake, Michael H
Lake, Michael H is an sole proprietor health care provider with primary practice located at 4450 Eau Gallie Blvd Suite 200, Melbourne FL 32934-7214. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Lake, Michael H can be contacted via phone (321) 726-2860.Contact Information
Primary practice address
4450 Eau Gallie Blvd Suite 200
Melbourne FL 32934-7214
Phone: (321) 726-2860
Fax: (321) 752-3143
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Social Worker | 104100000X | ||
Other Service Providers / Case Manager/Care Coordinator | 171M00000X | MH8204 | Florida |
Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | MH8204 | Florida |
Profile Details
NPI number | 1265596035 |
---|---|
LBN Legal business name | Lake, Michael H |
Credentials | LMHC |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Dec 19th, 2006 |
Last updated | Sep 25th, 2018 - about 6 years ago |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1265596035 | NPPES |
Florida | MEDICAID | 016517700 | |
Florida | MEDICAID | 000761700 |
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