MEDICARE: LANAE COMBS LCSW

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	1041C0700X	Clinical Social Worker	MSW009233	GA
2	1041C0700X	Clinical Social Worker	CSW009683	GA

General Provider Information

NPI Number	:	1164203915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LANAE COMBS LCSW

Provider Business Mailing Address
First Line	:	1445 WOODMONT LN NW # 2719
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-2866
Country	:	US
Telephone Number	:	770-988-5030
Fax Number	:

Provider Business Practice Location Address
First Line	:	1445 WOODMONT LN NW # 2719
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-2866
Country	:	US
Telephone Number	:	770-988-5030
Fax Number	:

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

Provider Enumeration Date	:	10/09/2023
Last Update Date	:	05/22/2026

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Directions to “ LANAE COMBS LCSW” Practice Location

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