Individual provider · Type 1 NPI

Dakota Micheal Lake, LCSW

Mental Health Counselor · Portland, OR

NPI number 1407628845 Active

Practice location

5441 S Macadam Ave
Portland, OR 97239-6106

Call (971) 415-5755 Map

Fax (971) 415-5855

Mailing address

4750 N Albina Ave Apt 406
Portland, OR 97217-2671

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XL11777 (OR)

Mental Health Counselor: Definition to come...

15 other providers at this address

Other mental health counselor providers in Portland

See all in Portland →

About NPI 1407628845

Dakota Micheal Lake, LCSW's National Provider Identifier is 1407628845, issued on Oct 30, 2023. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Mar 25, 2025.