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Organization
LAKE WELLNESS, LLC
Active
Organization
LAKE WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL H LAKE JR. M.S., L.M.H.C., Q.S. (PRESIDENT)
(321) 626-4513
Entity
Organization
Contact information
Practice address
590 SOLUTIONS WAY STE 120, ROCKLEDGE, FL 32955-3623
(321) 626-4513
Mailing address
590 SOLUTIONS WAY STE 120, ROCKLEDGE, FL 32955-3623
(321) 626-4513
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/25/2024
Last updated
08/05/2024
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