Amanda Kay Lake, is a
Marriage & Family Therapist based in Janesville, Wisconsin. Amanda Kay Lake is licensed to practice in Wisconsin (license number 903) and her current practice location is
113 S Franklin St, Janesville, Wisconsin. She can be reached at her office (for appointments etc.) via phone at
(608) 743-2417.
NPI number for Amanda Kay Lake is 1992998900 and her current mailing address is 113 S Franklin St, Janesville, Wisconsin. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1992998900.
Healthcare Provider's Profile
Full Name | Amanda Kay Lake |
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Gender | Female |
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Speciality | Marriage & Family Therapist |
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Location | 113 S Franklin St, Janesville, Wisconsin |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1992998900
- Provider Enumeration Date: 08/22/2007
- Last Update Date: 12/18/2014
Medical Identifiers
Medical identifiers for Amanda Kay Lake such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1992998900 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 10097 (Iowa) | Secondary |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 15750 (Wisconsin) | Secondary |
106H00000X | Marriage & Family Therapist | 000347 (Iowa) | Secondary |
106H00000X | Marriage & Family Therapist | 903 (Wisconsin) | Primary |
106H00000X | Marriage & Family Therapist | 166000869 (Illinois) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amanda Kay Lake is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Amanda Kay Lake, 113 S Franklin St, Janesville, WI 53548-3812 Ph: (608) 743-2417 | Amanda Kay Lake, 113 S Franklin St, Janesville, WI 53548-3812 Ph: (608) 743-2417 |
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