CANDACE LAKE MS LMHC PA (NPI# 1669094967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669094967 |
| Entity Type | Organization |
| Organization Name | CANDACE LAKE MS LMHC PA |
| Practice Address |
1650 Ne 26th St Ste 201 Wilton Manors FL 33305-1431 |
| Mailing Address |
2883 Ne 15th St Pompano Beach FL 33062-3611 |
| Practice Telephone | 5612710681 |
| Mailing Telephone | 5612710681 |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2020-05-11 |
| Authorized Official Name | MS. CANDACE RENEE LAKE (OWNER) |
| Authorized Official Telephone | 5612710681 |
| Authorized Official Credential | MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
1650 NE 26TH ST STE 201 |
| City | WILTON MANORS |
| State | FL |
| Zip Code | 33305-1431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295111623 | Toni Richardi | Psychologist | 1650 Ne 26th St Ste 201, Wilton Manors, FL 33305-1431 | 2015-08-07 |
| 1508382755 | Courtney J. Cantrell, Psy.d., Pa | Clinic/Center | 1650 Ne 26th St Ste 201, Wilton Manors, FL 33305-1431 | 2017-08-18 |
| 1740652072 | Courtney Cantrell | Psychologist | 1650 Ne 26th St Ste 201, Wilton Manors, FL 33305-1431 | 2015-10-26 |
| 1184095762 | Coastal Behavioral Health LLC | Psychologist | 1650 Ne 26th St Ste 201, Wilton Manors, FL 33305-1431 | 2015-10-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982244331 | Michael Moses Gans | Social Worker | 520 Ne 20th Street, #603, Wilton Manors, FL 33305 | 2020-01-14 |
| 1922650159 | Samantha Jones | Chiropractor | 1732 Ne 26th St Ste 201, Wilton Manors, FL 33305 | 2019-07-09 |
| 1033601653 | Neuro Intergration LLC | Psychologist | 2500 N Federal Hwy Ste 100, Fort Lauderdale, FL 33305 | 2018-05-30 |
| 1548775000 | Inbox Inc. | Counselor | 1650 Ne 26th St., Suite 206, Wilton Manors, FL 33305 | 2017-12-06 |
| 1306394168 | The 5 Elements Spa & Longevity Center | Health Maintenance Organization | 2288 Wilton Drive, Wilton Manors, FL 33305 | 2016-09-21 |
| 1467900449 | Crystal L Cacolici | Acupuncturist | 1732 Ne 26th St Ste 202, Wilton Manors, FL 33305 | 2016-09-19 |
| 1649634809 | Terri-ann Brown Arnp | Nurse Practitioner | 1881 Ne 26th Street, Suite 102, Fort Lauderdale, FL 33305 | 2016-04-13 |
| 1194130203 | Rhea Butchey | Optometrist | 2131 N Federal Hwy, Fort Lauderdale, FL 33305 | 2014-06-26 |
| 1891128732 | Ashton Pierce Thompson | Internal Medicine | 2449 Ne 13th Ave, Wilton Manors, FL 33305 | 2013-08-14 |
| 1427300789 | Kids In Distress | Foster Care Agency | 819 Ne 26th St., Ft. Laud, FL 33305 | 2012-10-11 |
| Find all providers in zip 33305 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093717464 | Care Resource Community Health Centers, Inc | Community/Behavioral Health | 871 W Oakland Park Blvd, Wilton Manors, FL 33311 | 2005-08-15 |
| 1659728459 | Bailey House of Wellness, LLC | Community/Behavioral Health | 1881 Ne 26th St, Suite 202a, Wilton Manors, FL 33305-1416 | 2016-05-21 |
| 1972979631 | Banyan Community Health Center, Inc | Community/Behavioral Health | 1061 W Oakland Park Blvd, Wilton Manors, FL 33311-1609 | 2015-08-18 |
| 1356771968 | Sunshine Social Service, Inc | Community/Behavioral Health | 2312 Wilton Dr, 200, Wilton Manors, FL 33305-1249 | 2013-11-18 |
| 1609200906 | Katharine Campbell Counseling & Consulting, LLC | Community/Behavioral Health | 1881 Ne 26th St, Suite 70, Wilton Manors, FL 33305-1416 | 2013-08-22 |
| 1437400272 | Kids In Distress | Community/Behavioral Health | 819 Ne 26th St, Wilton Manors, FL 33305-1239 | 2012-09-19 |
| 1457679839 | The Twelve for Children and Families of Florida, Inc. | Community/Behavioral Health | 1881 Ne 26th St, Suite 240, Wilton Manors, FL 33305-1416 | 2010-05-11 |
| 1124285614 | Kids In Distress | Community/Behavioral Health | 819 Ne 26th St, Wilton Manors, FL 33305-1239 | 2008-05-21 |
| 1144436296 | Maria L. Bondi Lmhc Dapa | Community/Behavioral Health | 1650 Ne 26th St, Suite 206, Wilton Manors, FL 33305-1431 | 2007-05-15 |
| 1720290380 | Valerie J. Elsbree, Msw, Cap, Pa | Community/Behavioral Health | 1650 Ne 26th St, Wilton Manors, FL 33305-1431 | 2007-05-04 |
| Find all providers in WILTON MANORS | ||||
| City | WILTON MANORS |
| Zip Code | 33305 |
Please comment or provide details below to improve the information on CANDACE LAKE MS LMHC PA.
| 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.