MELISSA ANN LAKE (NPI# 1003204827) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003204827 |
| Entity Type | Individual |
| Full Name | MELISSA ANN LAKE |
| Credential | PSY.D. |
| Practice Address |
4552 W Cottontail Rd Phoenix AZ 85086-1449 |
| Practice Telephone | 2012329916 |
| Mailing Telephone | 2012329916 |
| Enumeration Date | 2014-12-31 |
| Last Update Date | 2014-12-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | $$$$$$$$$ | AZ | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AHCCCS | 001533 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922584499 | Melissa Lake | Physician Assistant | 800 W Cummings Park Ste 1200, Woburn, MA 01801-6587 | 2018-07-17 |
| 1881047256 | Melissa Lake | Counselor | 647 Philadelphia St, Suite 403, Indiana, PA 15701-3923 | 2016-07-20 |
| 1275961682 | Melissa Marie Lake | Nurse Anesthetist, Certified Registered | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2013-10-22 |
| Street Address |
4552 W COTTONTAIL RD |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85086-1449 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760097703 | Cindy Ryanto | Pharmacist | 39508 W Daisy Mountain Dr, Phoenix, AZ 85086 | 2020-09-15 |
| 1912559857 | Cathey Michelle Allen | Massage Therapist | 39006 N 11th Ave, Phoenix, AZ 85086 | 2019-07-11 |
| 1174000871 | Anthem Eye Group Pllc | Optometrist | 4205 W Anthem Way #101, Anthem, AZ 85086 | 2018-07-25 |
| 1366982449 | Angela Ann Childs | Registered Nurse | 42104 N Venture Dr Ste D118, Anthem, AZ 85086 | 2017-03-08 |
| 1144772054 | Joe Bezerra | Specialist | 39818 N Bell Meadow Trl, Phoenix, AZ 85086 | 2016-10-26 |
| 1669821252 | Arizona Procedural Center | Clinic/Center | 3655 West Anthem Way, Suite 109 Box 272, Athem, AZ 85086 | 2016-06-06 |
| 1124499280 | Shane Carr | Physical Therapist | 39716 N 7th St, Phoenix, AZ 85086 | 2015-10-15 |
| 1790174167 | Kelly Christine Collins | Dermatology | 42211 N 41st Dr. #a109, Phoenix, AZ 85086 | 2015-01-22 |
| 1174953913 | Sung Ae Lee | Radiology | 820 W. Ravina Lane, Anthem, AZ 85086 | 2013-11-14 |
| 1881034080 | Bryan Michael Hays | Dentist | 40411 N Capra Way, Anthem, AZ 85086 | 2013-07-02 |
| Find all providers in zip 85086 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689298838 | Eboni Nicole Morris | Psychologist | 166001 N. 40th St., Suite 210, Phoenix, AZ 85032 | 2020-06-03 |
| 1407319486 | Joan Ledvina Parr | Psychologist | 13 Glenbrook Dr, Phoenix, MD 21131-2007 | 2019-04-08 |
| 1720591365 | Think Psychological and Consulting Services Pllc | Psychologist | 2632 S 83rd Ave Ste 100-481, Phoenix, AZ 85043-7206 | 2017-11-06 |
| 1558880682 | Christine Breuer | Psychologist | 21630 N 19th Ave Ste B17, Phoenix, AZ 85027-2715 | 2017-09-09 |
| 1093239048 | Emma Ross | Psychologist | 1919 E Thomas Rd Bldg 4th, Phoenix, AZ 85016 | 2017-08-01 |
| 1225584030 | Sojourner Health | Psychologist | 2224 E Fillmore St, Phoenix, AZ 85006-3815 | 2016-08-31 |
| 1346694627 | Sharareh Najafi | Psychologist | 3450 N. 3rd Street, Phoenix, AZ 85012 | 2016-04-22 |
| 1982097614 | T. M. Barratt | Psychologist | 3550 N. Central Ave. Suite 1407, Phoenix, AZ 85012 | 2015-03-04 |
| 1699196915 | Deborah Gladding | Psychologist | 36625 N 18th St, Phoenix, AZ 85086-5715 | 2014-01-05 |
| 1942634589 | Julie Marie Lesperance | Psychologist | 1401 W Washington St Ste 100, Phoenix, AZ 85007-2901 | 2013-08-31 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.