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Individual
MEGHAN LAKE
Active
Individual
MEGHAN LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12-03-26
OR
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
L6534
OR
Other
Enumeration date
09/15/2009
Last updated
05/25/2022
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