Healthcare Provider Details

I. General information

NPI: 1902294788
Provider Name (Legal Business Name): INGER LANESE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2015
Last Update Date: 12/28/2023
Certification Date: 12/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7521 WESTSHIRE DR STE 100
LANSING MI
48917-1105
US

IV. Provider business mailing address

PO BOX 10
MASON MI
48854-0010
US

V. Phone/Fax

Practice location:
  • Phone: 517-974-9664
  • Fax:
Mailing address:
  • Phone: 517-676-9788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6401014150
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: