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General NPI Number Information
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NPI Number | 1669995023
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Entity Type | Individual
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Provider Name | LAURA LANE LCPC
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Gender | Female
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Dates
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Enumeration Date | 07/18/2017
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Last Update Date | 05/31/2024
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Provider Practice Location Address
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Address Line | 90 AILERON CT STE 6A
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City | WESTMINSTER
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State | MD
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Zip | 21157-3012
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Country | US
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Telephone | 443-789-4258
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Fax | 410-848-5629
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Provider Business Mailing Address
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Address Line | 1651 SAINT PAUL ST
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City | HAMPSTEAD
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State | MD
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Zip | 21074-2116
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Country | US
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Telephone | 443-789-4258
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Fax | 410-848-5629
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC7940
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License Number State | MD
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