# MR. JAMES EVAN LAKE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1801556899
- **Gender:** Man
- **Credential:** MA, PC, ATR

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | C.0008277 | OH | Yes |
| 221700000X | Art Therapist | 21-169 | OH | — |

## Other

- **Enumeration date:** 12/18/2021
- **Last updated:** 12/18/2021