Healthcare Provider Details

I. General information

NPI: 1134045404
Provider Name (Legal Business Name): MARCIA HOCHMAN LANE MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MIKKI LANE MA

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 COURT SQ
RUTLAND VT
05701-4030
US

IV. Provider business mailing address

709 SCHOOLHOUSE HILL RD
WEST RUTLAND VT
05777-9832
US

V. Phone/Fax

Practice location:
  • Phone: 802-683-0019
  • Fax:
Mailing address:
  • Phone: 802-683-0019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number097.0136337
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: