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NPI Code Detail

MEDICARE: JORDYNN MICHELLE LANE LCSW

MEDICARE: JORDYNN MICHELLE 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 Worker149.030841IL

General Provider Information

NPI Number : 1851091367
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDYNN MICHELLE LANE LCSW
Provider Business Mailing Address
First Line : 4800 N SCOTTSDALE RD STE 2500
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-7630
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 55 S MAIN ST STE 252
Second Line :
City : NAPERVILLE
State : IL
Zip : 60540-5576
Country : US
Telephone Number : 630-428-7890
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2023
Last Update Date : 02/04/2026

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