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

Mr. Matthew R Lake

Individual provider Behavior Technician · NPI 1790326080

Mr. Matthew R Lake is a Behavior Technician in Warren, Michigan. Works from 2 locations. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

3601 E 11 Mile Rd
Warren, MI 48092-2878
Phone: (303) 989-8169
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 8285 S Saginaw St Ste 7, Grand Blanc, MI 48439-2436 — (810) 321-3001

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X

Record details

NPI number1790326080
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 8, 2019
Last updated in NPPESSeptember 29, 2020
Certification dateSeptember 29, 2020

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