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General NPI Number Information
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NPI Number | 1568178564
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Entity Type | Individual
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Provider Name | CHELSEA DEANE LANE LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/24/2023
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 1240 TENNOVA MEDICAL WAY
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City | KNOXVILLE
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State | TN
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Zip | 37909-3120
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Country | US
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Telephone | 865-444-3770
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Fax |
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Provider Business Mailing Address
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Address Line | 1709 HIGH ST
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City | WHITE PINE
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State | TN
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Zip | 37890-3251
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Country | US
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Telephone | 423-312-7561
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 13162
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 14584
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 9117
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License Number State | TN
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