Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MR. MATTHEW R LAKE
NPI 1790326080
Behavior Analyst in Warren, MI

Q: What is Matthew Lake's NPI number?

The NPI number for Matthew Lake is 1790326080. It was assigned to this individual provider in the NPPES registry on October 8, 2019.

Q: What is Matthew Lake's specialty?

The primary specialty registered for this NPI is Behavior Analyst with taxonomy code 103K00000X.

Q: When was this NPI record last updated?

The NPPES record for Matthew Lake was last updated on August 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 days 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.

Active since October 08, 2019

3601 E 11 MILE RD, WARREN, MI 48092(303) 989-8169 Get Directions Write a Review

NPPES record last updated: August 20, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 20, 2026, Sep 29, 2020, Oct 8, 2019 (3 updates tracked since 2019).

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About Mr. Matthew R Lake NPPES

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

MR. MATTHEW R LAKE (NPI 1790326080) is an individual behavior analyst provider in Warren, Michigan, licensed in Michigan (7401003468) and active in the NPI registry since October 2019. He maintains 2 additional practice locations.

NPPES Registry Identity

NPI1790326080

Entity TypeIndividualMale

Primary Taxonomy103K00000X

Provider Legal NameMR. MATTHEW R LAKE

Location Address3601 E 11 MILE RDWarren, MI 48092-2878

Mailing Address3601 E 11 Mile RdWarren, MI 48092-2878 · (303) 989-8169

Phone(303) 989-8169

Sole ProprietorNo

Enumeration DateOctober 8, 2019

Last NPPES UpdateAugust 20, 20263 updates tracked since enumeration

NPPES CertifiedAugust 20, 2026

✔ NPI 1790326080 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyBehavior AnalystBehavioral Health & Social Service Providers

Taxonomy Code103K00000X

License✔ Licensed in MI · 7401003468

Definition

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

3601 E 11 MILE RD, Warren, MI 48092

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Secondary Practice Locations 2

Location 18285 S Saginaw St Ste 7Grand Blanc, MI 48439-2436 · Phone (810) 321-3001

Location 24900 Mercury Dr Ste DDearborn, MI 48126-2947 · Phone (734) 203-7675

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.

MIKAYLA LEWIS

Behavior Technician