COREY LAKE CDCA, PRS-HS
NPI 1467220392
Counselor - Addiction (Substance Use Disorder) in Circleville, OH

Active since December 20, 2023
2065 STONERIDGE DR, CIRCLEVILLE, OH 43113(740) 500-1391 Get Directions Write a Review

NPPES record last updated: April 23, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Corey Lake Cdca, Prs-hs NPPES

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

COREY LAKE CDCA, PRS-HS (NPI 1467220392) is an individual addiction (substance use disorder) provider in Circleville, Ohio, licensed in Ohio (CDCA.192016) and active in the NPI registry since December 2023. He maintains 2 additional practice locations.

NPPES Registry Identity

NPI1467220392
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameCOREY LAKECredential: CDCA, PRS-HS
Location Address2065 STONERIDGE DRCircleville, OH 43113-8956
Mailing Address2065 Stoneridge DrCircleville, OH 43113-8956 · (740) 500-1391
Sole ProprietorNo
Enumeration DateDecember 20, 2023
Last NPPES UpdateApril 23, 2025
NPPES CertifiedApril 23, 2025
NPI 1467220392 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License Licensed in OH · CDCA.192016
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
Also ListedPeer SpecialistTaxonomy 175T00000X · License APS.004709 (OH)
2065 STONERIDGE DR, Circleville, OH 43113

Secondary Practice Locations 2

Location 11235 S Court StCircleville, OH 43113-2108 · Phone (740) 500-1391
Location 21875 Stoneridge DrCircleville, OH 43113-8956 · Phone (740) 500-1391

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.

Licensed Practical Nurse
2065 STONERIDGE DR
CIRCLEVILLE, OH 43113
Peer Specialist
2065 STONERIDGE DR
CIRCLEVILLE, OH 43113
Counselor (Addiction (Substance Use Disorder))
2065 STONERIDGE DR
CIRCLEVILLE, OH 43113
Counselor (Addiction (Substance Use Disorder))
2065 STONERIDGE DR
CIRCLEVILLE, OH 43113
Counselor (Addiction (Substance Use Disorder))
2065 STONERIDGE DR
CIRCLEVILLE, OH 43113
Case Manager/Care Coordinator
2065 STONERIDGE DR
CIRCLEVILLE, OH 43113
Case Manager/Care Coordinator
2065 STONERIDGE DR
CIRCLEVILLE, OH 43113
Licensed Practical Nurse
2065 STONERIDGE DR
CIRCLEVILLE, OH 43113

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 Corey Lake's NPI number?

The NPI number for Corey Lake is 1467220392. It was assigned to this individual provider in the NPPES registry on December 20, 2023.

Where is Corey Lake located?

Corey Lake practices at 2065 Stoneridge Dr, Circleville, OH 43113. The listed phone number is (740) 500-1391.

What is Corey Lake's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Corey Lake was last updated on April 23, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.