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General NPI Number Information
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NPI Number | 1598438491
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Entity Type | Individual
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Provider Name | LANCE LASHLEY LCSW
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Gender | Male
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Dates
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Enumeration Date | 07/27/2021
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 649 HARKLE RD STE E
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City | SANTA FE
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State | NM
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Zip | 87505-4765
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Country | US
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Telephone | 505-955-9454
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Fax | 505-216-9067
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Provider Business Mailing Address
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Address Line | 122 MORADA LN UNIT 2
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City | TAOS
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State | NM
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Zip | 87571-6893
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Country | US
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Telephone | 678-334-6879
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C-12181
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 095400
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License Number State | IA
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