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).
| 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 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers |
| Street Address |
261 MACK AVE STE 555 |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942339528 | Richard Anthony Caprio | Psychologist | 261 Mack Ave Ste 555, Detroit, MI 48201-2417 | 2007-03-02 |
| 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 Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| 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] |
| 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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| 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.