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General NPI Number Information
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NPI Number | 1417013996
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Entity Type | Individual
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Provider Name | MICHELE K LANE LCSW, BCD
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Gender | Female
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6300 WEST LOOP S SUITE 215
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City | BELLAIRE
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State | TX
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Zip | 77401-2900
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Country | US
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Telephone | 713-668-3838
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Fax | 713-663-6664
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Provider Business Mailing Address
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Address Line | 5300 N BRAESWOOD BLVD STE 224
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City | HOUSTON
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State | TX
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Zip | 77096-3307
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Country | US
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Telephone | 713-668-3838
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Fax | 713-663-6664
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 18367
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License Number State | TX
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