MEDICARE: KENDELL M. LANE LSW

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
1	101YM0800X	Mental Health Counselor	33011693A	IN

General Provider Information

NPI Number	:	1811830169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENDELL M. LANE LSW

Provider Business Mailing Address
First Line	:	7918 PENOBSCOT DR APT E
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46239-2234
Country	:	US
Telephone Number	:	317-516-9191
Fax Number	:

Provider Business Practice Location Address
First Line	:	7918 PENOBSCOT DR APT E
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46239-2234
Country	:	US
Telephone Number	:	317-516-9191
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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Directions to “ KENDELL M. LANE LSW” Practice Location

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