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MS. AMANDA MARIE LAKE MA CCC-SLP
NPI 1184954000
Speech-Language Pathologist in Dewitt, MI

Active since December 29, 2009
124 E WASHINGTON ST STE C, DEWITT, MI 48820(517) 282-7779(517) 394-3604 Get Directions Write a Review

NPPES record last updated: July 10, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jul 10, 2025, Mar 31, 2025 (2 updates tracked since 2025).

About Ms. Amanda Marie Lake Ma Ccc-slp NPPES

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

MS. AMANDA MARIE LAKE MA CCC-SLP (NPI 1184954000) is an individual speech-language pathologist provider in Dewitt, Michigan and active in the NPI registry since December 2009.

NPPES Registry Identity

NPI1184954000
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameMS. AMANDA MARIE LAKECredential: MA CCC-SLP
Location Address124 E WASHINGTON ST STE CDewitt, MI 48820-8826
Mailing AddressPo Box 794Okemos, MI 48805-0794 · (517) 282-7779 · Fax (517) 394-3604
Phone(517) 282-7779
Fax(517) 394-3604
Sole ProprietorYes
Enumeration DateDecember 29, 2009
Last NPPES UpdateJuly 10, 20252 updates tracked since enumeration
NPPES CertifiedJuly 10, 2025
✔ NPI 1184954000 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
124 E WASHINGTON ST STE C, Dewitt, MI 48820
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Amanda Marie Lake Ma Ccc-slp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Amanda Lake reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Practical Rehabilitation Services, LLC
Same address
Speech-Language Pathologist
124 E WASHINGTON ST STE C
Dewitt, MI 48820
  • Reassigned Medicare billing, Michigan enrollment
NPI 1306155742 (855) 777-9297

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 2

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

PRACTICAL REHABILITATION SERVICES, LLC
Speech-Language Pathologist
124 E WASHINGTON ST STE C
DEWITT, MI 48820
Clinton County (855) 777-9297
CORINNE HOEDEMAN SLP-CCC
Speech-Language Pathologist
124 E WASHINGTON ST STE C
DEWITT, MI 48820
Clinton County (855) 777-9297

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 Amanda Lake's NPI number?

The NPI number for Amanda Lake is 1184954000. It was assigned to this individual provider in the NPPES registry on December 29, 2009.

Where is Amanda Lake located?

Amanda Lake practices at 124 E Washington St Ste C, Dewitt, MI 48820. The listed phone number is (517) 282-7779.

What is Amanda Lake's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Amanda Lake enrolled in Medicare?

Yes. Amanda Lake is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Amanda Lake's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amanda Lake reassigns Medicare benefits to Practical Rehabilitation Services, LLC (Dewitt, MI). The 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 Amanda Lake's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Amanda Lake was last updated on July 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.