| Michelle Lake, LPC | |
|
205 N East Ave, Jackson, MI 49201-1753 | |
| (517) 205-5971 | |
| (517) 789-5918 |
| Full Name | Michelle Lake |
|---|---|
| Gender | Female |
| Speciality | Mental Health Counselor |
| Experience | 7 Years |
| Location | 205 N East Ave, Jackson, Michigan |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720533581 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 6401017419 (Michigan) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| W. A. Foote Memorial Hospital, Inc. | 0244136067 | 476 |
| Entity Name | W. A. Foote Memorial Hospital, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326078866 PECOS PAC ID: 0244136067 Enrollment ID: O20031215000361 |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle Lake, LPC 1 Ford Pl Ste 3a, Detroit, MI 48202-3450 Ph: (313) 874-4806 | Michelle Lake, LPC 205 N East Ave, Jackson, MI 49201-1753 Ph: (517) 205-5971 |
Mrs. Juliana Moore, LPC Counselor Medicare: May Accept Medicare Assignments Practice Location: 2692 N Dettman Rd, Jackson, MI 49201 Phone: 517-612-9902 |
Lavonda Bouler, Counselor Medicare: Not Enrolled in Medicare Practice Location: 720 W Franklin St, Jackson, MI 49201 Phone: 734-726-4038 |
Samuel Bommarito, LLPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 300 W Washington Ave Ste 210b, Jackson, MI 49201 Phone: 517-344-0913 Fax: 517-905-6007 |
Ms. Deborah Ann Mcdonald, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 323 W Michigan Ave, Jackson, MI 49201 Phone: 517-783-2732 |
Mrs. Rosemary Jordon Beals, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1200 N West Ave, Jackson, MI 49202 Phone: 517-783-5334 Fax: 517-783-6064 |
Eric G Kelly, LLMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 6692 Spring Arbor Rd, Jackson, MI 49201 Phone: 517-750-3869 |
Mr. Michael Lee Freytag, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1200 N West Ave, Suite 400, Jackson, MI 49202 Phone: 517-474-3793 Fax: 517-796-4561 |