Healthcare Provider Details

I. General information

NPI: 1023196664
Provider Name (Legal Business Name): NANCY E. LANEY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 W NC HIGHWAY 54 SUITE 210
DURHAM NC
27707-5574
US

IV. Provider business mailing address

1515 W NC HIGHWAY 54 SUITE 210
DURHAM NC
27707-5574
US

V. Phone/Fax

Practice location:
  • Phone: 919-641-6866
  • Fax:
Mailing address:
  • Phone: 919-641-6866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS 007133-L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2555
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number2555
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number2555
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number2555
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number2555
License Number StateNC
# 7
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number2555
License Number StateNC
# 8
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number2555
License Number StateNC
# 9
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number2555
License Number StateNC
# 10
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number2555
License Number StateNC
# 11
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number2555
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: