Dr Candice M Lake, BCBA-D, LLP is a
Behavior Analyst based in Grand Rapids, Michigan. Dr Candice M Lake is licensed to practice in Michigan (license number 01-07-3561) and her current practice location is
1260 Ekhart St Ne, Grand Rapids, Michigan. She can be reached at her office (for appointments etc.) via phone at
(616) 965-3470.
NPI number for Dr Candice M Lake is 1285918193 and her current mailing address is 3300 36th St Se, Grand Rapids, Michigan. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1285918193.
Healthcare Provider's Profile
Full Name | Dr Candice M Lake |
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Gender | Female |
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Speciality | Behavior Analyst |
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Location | 1260 Ekhart St Ne, Grand Rapids, Michigan |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1285918193
- Provider Enumeration Date: 10/11/2011
- Last Update Date: 03/21/2016
Medical Identifiers
Medical identifiers for Dr Candice M Lake such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1285918193 | NPI | - | NPPES |
10025695700 | Medicaid | NE | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103T00000X | Psychologist | 6301016173 (Michigan) | Secondary |
103K00000X | Behavior Analyst | 01-07-3561 (Michigan) | Primary |
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. Dr Candice M 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 |
Dr Candice M Lake, BCBA-D, LLP 3300 36th St Se, Grand Rapids, MI 49512-2810 Ph: (616) 965-3470 | Dr Candice M Lake, BCBA-D, LLP 1260 Ekhart St Ne, Grand Rapids, MI 49503-1380 Ph: (616) 965-3470 |
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