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SAMANTHA RAE LAKE LICSW
NPI 1740852284
Social Worker - Clinical in Brainerd, MN

Active since July 14, 2021
823 MAPLE ST, BRAINERD, MN 56401(218) 454-3826 Get Directions Write a Review

NPPES record last updated: August 21, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 21, 2024, Aug 5, 2021, Jul 14, 2021 (3 updates tracked since 2021).

About Samantha Rae Lake Licsw NPPES

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

SAMANTHA RAE LAKE LICSW (NPI 1740852284) is an individual clinical provider in Brainerd, Minnesota and active in the NPI registry since July 2021. She maintains a secondary practice location in Little Falls.

NPPES Registry Identity

NPI1740852284
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSAMANTHA RAE LAKECredential: LICSW
Location Address823 MAPLE STBrainerd, MN 56401-3770
Mailing Address823 Maple StBrainerd, MN 56401-3770
Phone(218) 454-3826
Sole ProprietorNo
Enumeration DateJuly 14, 2021
Last NPPES UpdateAugust 21, 20243 updates tracked since enumeration
NPPES CertifiedAugust 21, 2024
✔ NPI 1740852284 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedSocial WorkerTaxonomy 104100000X · License 26980 (MN)
823 MAPLE ST, Brainerd, MN 56401
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Secondary Practice Location 1

Location 1101 9th St SELittle Falls, MN 56345-3359 · Phone (320) 616-3200

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.

MRS. BETHANY ROSE NORDBY LICSW
Social Worker (Clinical)
823 MAPLE ST
BRAINERD, MN 56401
Crow Wing County (218) 454-4065
AMANDA MARY KAMPA MSW, LICSW
Social Worker (Clinical)
823 MAPLE ST
BRAINERD, MN 56401
Crow Wing County (218) 454-3826
MR. SHAWN S MCNALLY LICSW
Social Worker (Clinical)
823 MAPLE ST
BRAINERD, MN 56401
Crow Wing County (218) 454-3826
LUKE WILLIAM BORKENHAGEN MSW, LICSW
Social Worker (Clinical)
823 MAPLE ST
BRAINERD, MN 56401
Crow Wing County (218) 454-3826
STEPHANIE SILGJORD MSW, LICSW
Social Worker (Clinical)
823 MAPLE ST
BRAINERD, MN 56401
Crow Wing County (320) 733-4071
CATRINA KAY HELSETH LICSW
Social Worker (Clinical)
823 MAPLE ST
BRAINERD, MN 56401
Crow Wing County (218) 330-8474
MRS. SAMI CROSS LPCC
Counselor (Mental Health)
823 MAPLE ST
BRAINERD, MN 56401
Crow Wing County (218) 820-0011
KELSEY DAGEN MA, ATR, LMFT
Marriage & Family Therapist
823 MAPLE ST
BRAINERD, MN 56401
Crow Wing County (218) 454-3826

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 Samantha Lake's NPI number?

The NPI number for Samantha Lake is 1740852284. It was assigned to this individual provider in the NPPES registry on July 14, 2021.

Where is Samantha Lake located?

Samantha Lake practices at 823 Maple St, Brainerd, MN 56401. The listed phone number is (218) 454-3826.

What is Samantha Lake's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Samantha Lake was last updated on August 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.