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BRADLEY ALLAN LAKE LMSW
NPI 1083261705
Social Worker in Detroit, MI

Active since August 19, 2019PECOS EnrolledAccepts Medicare Assignment
2925 RUSSELL ST, DETROIT, MI 48207(313) 396-5300(313) 396-5353 Get Directions Write a Review

NPPES record last updated: July 12, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 12, 2022, Aug 19, 2019 (2 updates tracked since 2019).

About Bradley Allan Lake Lmsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRADLEY ALLAN LAKE LMSW (NPI 1083261705) is an individual social worker in Detroit, Michigan, licensed in Michigan (6801113780) and active in the NPI registry since August 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1083261705
Entity TypeIndividualMale
Primary Taxonomy104100000X
Provider Legal NameBRADLEY ALLAN LAKECredential: LMSW
Location Address2925 RUSSELL STDetroit, MI 48207-4825
Mailing Address4131 Clippert StDearborn Heights, MI 48125-2732 · (313) 680-0019
Phone(313) 396-5300
Fax(313) 396-5353
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateAugust 19, 2019
Last NPPES UpdateJuly 12, 20222 updates tracked since enumeration
NPPES CertifiedJuly 12, 2022
✔ NPI 1083261705 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in MI · 6801113780
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License 6801113780 (MI)
2925 RUSSELL ST, Detroit, MI 48207
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Bradley Allan Lake Lmsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID648663419
PECOS Enrollment IDI20220201000183
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Bradley Lake reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Team Wellness Center
Same address
Community Health
2925 RUSSELL ST
Detroit, MI 48207
  • Reassigned Medicare billing, Michigan enrollment
  • Medicare enrollment name: Team Mental Health Services Inc
  • 116 clinicians in this Medicare group
NPI 1588855100 (313) 396-5300
Richard Kneip, Ph.D., P.C.
32 mi
Community/Behavioral Health
6548 TOWN CENTER DR STE D
Clarkston, MI 48346
  • Reassigned Medicare billing, Michigan enrollment
  • Medicare enrollment name: Richard Kneip Phd PC
  • 347 clinicians in this Medicare group
NPI 1679739700 (800) 693-1916

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARCIA M WICKER RN
Registered Nurse
2925 RUSSELL ST
DETROIT, MI 48207
Wayne County (313) 396-5300
SAMARA JOHNSON
Social Worker (Clinical)
2925 RUSSELL ST
DETROIT, MI 48207
Wayne County (888) 813-8326
MS. CATHY LYNN EUSEARY CARE COORDINATOR
Case Manager/Care Coordinator
2925 RUSSELL ST
DETROIT, MI 48207
Wayne County (313) 396-5300
CAMILLA YAVETTE WILLIAMS MSW
Social Worker (Clinical)
2925 RUSSELL ST
DETROIT, MI 48207
Wayne County (313) 396-5300
BRIDGET MYKE CTRS
Recreation Therapist
2925 RUSSELL ST
DETROIT, MI 48207
Wayne County (313) 396-5300
AUSTIN DAVID URLAUB LLMSW, DP-C
Social Worker
2925 RUSSELL ST
DETROIT, MI 48207
Wayne County (313) 396-5300
SANDRA FAYE DEH
Case Manager/Care Coordinator
2925 RUSSELL ST
DETROIT, MI 48207
Wayne County (313) 396-5300
MRS. TONI RENEE BUNTON MSW
Social Worker (Clinical)
2925 RUSSELL ST
DETROIT, MI 48207
Wayne County (313) 389-3963

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bradley Lake's NPI number?

The NPI number for Bradley Lake is 1083261705. It was assigned to this individual provider in the NPPES registry on August 19, 2019.

Where is Bradley Lake located?

Bradley Lake practices at 2925 Russell St, Detroit, MI 48207. The listed phone number is (313) 396-5300.

What is Bradley Lake's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Bradley Lake enrolled in Medicare?

Yes. Bradley Lake is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Bradley Lake's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Bradley Lake reassigns Medicare benefits to 2 organizations: Team Wellness Center (Detroit, MI) and Richard Kneip, Ph.D., P.C. (Clarkston, MI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Bradley Lake's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Bradley Lake accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company, Priority Health and UnitedHealthcare list Bradley Lake as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Bradley Lake was last updated on July 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.