DR. MONICA LAKE (PSYD, NCSP) – Psychologist, NPI 1942745245

DR. MONICA LAKE (PSYD, NCSP) is a healthcare provider. based in Brandon, Florida. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSYD, NCSP. They hold a License No. PY10384 (FL). The NPI Number for DR. MONICA LAKE (PSYD, NCSP) is 1942745245

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
DR. MONICA LAKE (PSYD, NCSP)
NPI
1942745245
Phone
(813) 444-8760
Address
130 E BLOOMINGDALE AVE
Enumeration Date
23 December 2016
Last Update Date
8 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8134448760
Graduation Year
2013 (13 years ago)
PAC ID
4486084555
Group Practice PAC ID
7113357286
Professional Enrollment ID
I20210416001039
Address ID
FL335118101BR130XXAVEX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness85
Years active:9State licenses:1Digital endpointsOther names

1,602 CLINICAL PSYCHOLOGIST in FL

Provider Addresses for DR. MONICA LAKE (PSYD, NCSP)

  • 130 E BLOOMINGDALE AVE

    BRANDON, FL 335118101

    Phone: (813) 444-8760

    Type: Mailing

  • 10823, Boyette Road, Riverview, Hillsborough County, Florida, 33569, United States

    RIVERVIEW, FL 335698012

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-04-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210416001039IClinical PsychologistFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33511)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7113357286View full group profile
NameSpecialtyState
P S Y C H I A T R YVA
Clinical Social WorkerFL
Clinical PsychologistFL
Mental Health CounselorFL

Reviews

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Frequently asked questions

Can I use this page to confirm DR. MONICA LAKE (PSYD, NCSP)'s NPI?
Yes. DR. MONICA LAKE (PSYD, NCSP) is listed with NPI 1942745245 in the public NPI dataset.
Can I rely on DR. MONICA LAKE (PSYD, NCSP) being an active provider?
As of the registry snapshot, DR. MONICA LAKE (PSYD, NCSP) is marked active.
What is DR. MONICA LAKE (PSYD, NCSP)'s specialty?
The listing groups DR. MONICA LAKE (PSYD, NCSP) with Psychologist. Clinical services aligned with this taxonomy classification.
What address line appears for DR. MONICA LAKE (PSYD, NCSP)?
DR. MONICA LAKE (PSYD, NCSP)'s geographic hint is Brandon, Florida in our summary view.
Is the information about DR. MONICA LAKE (PSYD, NCSP) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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