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General NPI Number Information
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NPI Number | 1578795571
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Entity Type | Individual
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Provider Name | JACQUELINE LANE M.S.W, L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 08/10/2009
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Last Update Date | 08/19/2022
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Provider Practice Location Address
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Address Line | 609 W LITTLETON BLVD STE 309
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City | LITTLETON
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State | CO
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Zip | 80120-2352
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Country | US
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Telephone | 720-251-5628
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Fax | 844-203-9934
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Provider Business Mailing Address
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Address Line | 609 W. LITTLETON BLVD SUITE 309
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City | LITTLETON
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State | CO
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Zip | 80120-2352
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Country | US
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Telephone | 720-251-5628
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Fax | 844-203-9934
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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 |
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License Number State |
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