Individual provider · Type 1 NPI

Michael H. Lake Jr., LMHC

Mental Health Counselor · Melbourne, FL

NPI number 1265596035 Active

Practice location

4450 Eau Gallie Blvd, Suite 200
Melbourne, FL 32934-7214

Call (321) 726-2860 Map

Fax (321) 752-3143

Mailing address

400 East Sheridan Rd
Melbourne, FL 32901-3122

Specialties and licenses

TaxonomyCodeLicense
Social Worker 104100000XNone listed
Case Manager/Care Coordinator 171M00000XMH8204 (FL)
Mental Health Counselor Primary 101YM0800XMH8204 (FL)

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About NPI 1265596035

Michael H. Lake Jr., LMHC's National Provider Identifier is 1265596035, issued on Dec 19, 2006. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Melbourne, FL. The record was last updated on Sep 25, 2018.