Healthcare Provider Details

I. General information

NPI: 1043832959
Provider Name (Legal Business Name): LANE & CONTRIBUTORS COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2020
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4920 PLAINFIELD AVE NE STE D
GRAND RAPIDS MI
49525-1010
US

IV. Provider business mailing address

4920 PLAINFIELD AVE NE STE D
GRAND RAPIDS MI
49525-1010
US

V. Phone/Fax

Practice location:
  • Phone: 832-551-6115
  • Fax:
Mailing address:
  • Phone: 832-551-6115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: AMBER C LANE
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 713-257-8838