NPI age
19 years
Enumerated 2006-09-07
● Active
Type 1 · Individual
Marlyn A Lake, MD
Lake is 1 of 16 psychiatry & neurology providers in MacOn and 1 of 681 in Georgia.
Primary specialty
Psychiatry & Neurology
Plus 1 subspecialty
Licensed in
GA, FL
2 states
Status
Active
No deactivations on record
Last NPPES update
2022-04-14
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 681 active psychiatry & neurology providers in Georgia.
NPI age
19 years
↑ 2 yr above median (17 yr)
State licenses
2 states
Top 81% — 18% of peers are multi-state
Subspecialties
0
35% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-09Enumerated in NPPES
2006
2026
Where they practice
Practice location
380 Hospital Dr Ste 370
MacOn, GA 312178010
Mailing address
Po Box 417
Stuart, FL 349950417
Additional practice locations
4 secondary locations on file with NPPES.
Location 2
1425 Malabar Rd Ne
Palm Bay, FL 329072506
Location 3
608 S 9th St, Ste A
Leesburg, FL 347486390
Location 4
1768 Business Center Dr Ste 100
Reston, VA 201905359
Location 5
200 Se Hospital Ave
Stuart, FL 349942346
Specialties
-
Psychiatry & Neurology PrimaryA Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (FL) | NT772 | FL HF MEDICARE |
| 05 (FL) | 257303200 | |
| 01 (FL) | 44751 | BCBS |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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