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

Nicole Lake

Individual provider Counselor · NPI 1285211300

Nicole Lake is a Clinical Social Worker in Portsmouth, New Hampshire. Qualified in 2018, 8 years ago. Practices with Wentworth Douglass Physician Corporation, a 431-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New Hampshire.

Years since qualifying
8
Licensed in
NH
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

67 Corporate Dr
Portsmouth, NH 03801-2847
Phone: (603) 610-8050
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3250 Hospital Dr, Juneau, AK 99801-7808 — (907) 796-8690

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 5025 (NH)
Counselor Taxonomy 101Y00000X

Record details

NPI number1285211300
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 25, 2021
Last updated in NPPESJuly 26, 2024
Certification dateJuly 26, 2024
Mailing addressPo Box 412503, Boston, MA 02241-2503

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Wentworth Douglass Physician Corporation — 431 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Portsmouth