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General NPI Number Information
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NPI Number | 1770146250
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Entity Type | Individual
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Provider Name | BETHANY A LANIER LPC, LSATP
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Gender | Female
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Dates
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Enumeration Date | 04/19/2019
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | 5673 AIRPORT RD
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City | ROANOKE
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State | VA
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Zip | 24012-1119
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Country | US
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Telephone | 540-523-8080
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Fax |
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Provider Business Mailing Address
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Address Line | 1304 GREENDALE DR
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City | BLACKSBURG
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State | VA
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Zip | 24060-2617
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Country | US
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Telephone | 334-740-3872
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701009728
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License Number State | VA
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