Bradley Allan Lake, LMSW
NPI 1083261705ActiveIndividual· Social Worker· Detroit, MI
Social Worker (LMSW) with Richard Kneip PHD PC, practicing in Detroit, Michigan. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1083261705 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LMSW |
| Sole proprietor | No |
| NPI issued | Aug 19, 2019 |
| Last updated in NPPES | Jul 12, 2022 |
| Certified by provider | Jul 12, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker Primary | 104100000X | 6801113780 | MI |
| Social Worker, Clinical | 1041C0700X | 6801113780 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (MI) |
|---|
Education and affiliations
| Graduation year | 2019 |
|---|---|
| Medicare specialty | Clinical Social Worker |
| Telehealth | Offers telehealth |
Medical group
- Richard Kneip PHD PCClarkston, MI · 247 clinicians
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