Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lake Neurodiversity, LLC

Organization School Psychologist · NPI 1790544658

Lake Neurodiversity, LLC is a School Psychologist in Leesburg, Florida. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

711 W Main St Ste 127
Leesburg, FL 34748-5128
Phone: (352) 460-1925
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

School Psychologist (primary) Taxonomy 103TS0200X

Record details

NPI number1790544658
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Susan Andrews — Co-Owner, Psychologist · (352) 348-6989
NPI enumeratedMarch 14, 2024
Last updated in NPPESMarch 14, 2024
Certification dateMarch 14, 2024
Mailing address711 W Main St Ste 127, Leesburg, FL 34748-5128

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