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NPI Code Detail

MEDICARE: STEPHANIE LANE LCSW

MEDICARE: STEPHANIE LANE LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerC010947NC

General Provider Information

NPI Number : 1689042319
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE LANE LCSW
Provider Business Mailing Address
First Line : 7 OAK BRANCH DR
Second Line :
City : GREENSBORO
State : NC
Zip : 27407-2380
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7 OAK BRANCH DR
Second Line :
City : GREENSBORO
State : NC
Zip : 27407-2380
Country : US
Telephone Number : 704-222-4717
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2015
Last Update Date : 09/28/2017

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Directions to “ STEPHANIE LANE LCSW” Practice Location

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