MEDICARE: DR. MILDRED D. LANE ED.D., NCC, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	PC000357	PA

General Provider Information

NPI Number	:	1033284542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MILDRED D. LANE ED.D., NCC, LPC

Provider Business Mailing Address
First Line	:	1605 SAPLING DR
Second Line	:
City	:	ALLISON PARK
State	:	PA
Zip	:	15101-4020
Country	:	US
Telephone Number	:	412-486-1785
Fax Number	:	412-396-1340

Provider Business Practice Location Address
First Line	:	5000 MCKNIGHT RD
Second Line	:	SUITE 305
City	:	PITTSBURGH
State	:	PA
Zip	:	15237-3420
Country	:	US
Telephone Number	:	412-486-1785
Fax Number	:	412-396-4159

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	07/08/2007

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