Healthcare Provider Details

I. General information

NPI: 1619016292
Provider Name (Legal Business Name): ELAINE J LANE LPC, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 CANAL ST STE 325
NEW ORLEANS LA
70119-6059
US

IV. Provider business mailing address

1242 KINGS ROW
SLIDELL LA
70461-4434
US

V. Phone/Fax

Practice location:
  • Phone: 504-483-3551
  • Fax: 504-483-3551
Mailing address:
  • Phone: 504-319-8616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2864
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2864
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number888
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: