Stephanie Denise Lake, LMSW
Social Worker in Dearborn, MI. Individual provider (NPI-1).
NPI number1871008367
StatusActive
Last updated in NPPESDec 14, 2022
Details
- NPI
- 1871008367
- Entity type
- Individual (NPI-1)
- Name
- Stephanie Denise Lake
- Credential
- LMSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 6, 2017
- Certification date
- Sep 7, 2022
- Last updated
- Dec 14, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 104100000X | Social Worker | 6801109246 | MI | Yes |
| 1041C0700X | Social Worker, Clinical | – | – |
Practice location
3501 Harding StDearborn, MI 48124-3731
Phone 313-608-5544
Mailing address
23131 Michigan Ave # 1168Dearborn, MI 48124-2020
Phone 313-608-5544
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All 120 Social Worker providers in Dearborn · All 7,276 providers in Dearborn
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