DR. ALLISON JOSEPHINE LAKE


Address: 261 Mack Ave Ste 555, Detroit, MI 48201-2417
Phone: 3137459763

DR. ALLISON JOSEPHINE LAKE (NPI# 1285116384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1285116384
Entity Type Individual
Full Name DR. ALLISON JOSEPHINE LAKE
Credential PH.D.
Practice Address 261 Mack Ave Ste 555
Detroit
MI 48201-2417
Practice Telephone 3137459763
Practice Fax Number 3137459845
Mailing Telephone 3137459763
Mailing Fax Number 3137459845
Enumeration Date 2018-09-05
Last Update Date 2020-10-02
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103G00000X Clinical Neuropsychologist Behavioral Health & Social Service Providers

Office Location

Street Address 261 MACK AVE STE 555
City DETROIT
State MI
Zip Code 48201-2417

Providers in the same location

NPI Name Taxonomy Address Enumeration
1942339528 Richard Anthony Caprio Psychologist 261 Mack Ave Ste 555, Detroit, MI 48201-2417 2007-03-02

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1659989838 Saima Sharif Student in an Organized Health Care Education/Training Program 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 2020-07-14
1609494384 Praveen Kumar Boddu Student in an Organized Health Care Education/Training Program 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 2020-07-09
1730707720 Amr Hassan Abdelghaffar Omar Pediatrics 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 2020-07-07
1700400694 Hassan Imtiaz Student in an Organized Health Care Education/Training Program 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 2020-06-05
1598389074 Alaa Awad Elkarim Student in an Organized Health Care Education/Training Program 3901 Beaubien St. 3t72, Detroit, MI 48201 2020-06-01
1891319299 Jeongyeon Hwang Student in an Organized Health Care Education/Training Program 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 2020-06-01
1477176576 Jaudat Fatima Masood Student in an Organized Health Care Education/Training Program 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 2020-05-22
1205459419 Amit Kumar Dahiya Student in an Organized Health Care Education/Training Program 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 2020-05-21
1851914188 Asra Nausheen Shaik Student in an Organized Health Care Education/Training Program 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 2020-05-21
1568085751 Camille Olechowski Student in an Organized Health Care Education/Training Program 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 2020-05-21
Find all providers in zip 48201

Taxonomy Information

Taxonomy Code 103G00000X
Grouping Behavioral Health & Social Service Providers
Classification Clinical Neuropsychologist

Taxonomy Definition

An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning.
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1588828453 Jin Lee Kim Clinical Neuropsychologist 1 Ford Pl Ste 1e, Detroit, MI 48202-3450 2008-07-10
1841340312 Raymond Mckinley Campbell IIi Clinical Neuropsychologist 1511 1st St, Suite 1308, Detroit, MI 48226-1351 2007-01-10
1104939107 Jannel M Phillips Clinical Neuropsychologist 1 Ford Place, Detroit, MI 48202 2006-08-16
1952330474 Univeristy Affiliated Neurologists Clinical Neuropsychologist 4201 St. Antoine St, Suite 8d, Detroit, MI 48201 2006-06-30
1457390254 University Physician Group Clinical Neuropsychologist 4201 Saint Antoine St., Suite 8d, Detroit, MI 48201 2006-06-06
1225038904 Scott Richard Millis Clinical Neuropsychologist 261 Mack Ave, Rehabilitation Institute of Michigan, Rm 552, Detroit, MI 48201-2417 2005-07-26
1487193207 Vilija Petrauskas Clinical Neuropsychologist 1 Ford Pl Ste 1e, Detroit, MI 48202-3450 2017-02-13
1053659482 Brent Funk Clinical Neuropsychologist 1 Ford Pl, 1e, Detroit, MI 48202-3450 2013-01-18
1215295191 Kathleen Margaret Hagelthorn Clinical Neuropsychologist 1 Ford Pl Ste 2e, Detroit, MI 48202-3450 2012-04-27
1063741270 Adult Neuropsychology Clinical Neuropsychologist 4201 Saint Antoine St, 4j Uhc, Detroit, MI 48201-2153 2009-12-17
Find all providers in DETROIT

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City DETROIT
Zip Code 48201

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Dataset Information

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.

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