MEDICARE: LINDA LANEY 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	101Y00000X	Counselor	1408	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4066269	OTHER	TN	BLUE CROSS BLUE SHIELD TN

General Provider Information

NPI Number	:	1316961857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA LANEY LPC

Provider Business Mailing Address
First Line	:	759 BEAR CREEK RD
Second Line	:
City	:	PINSON
State	:	TN
Zip	:	38366-1911
Country	:	US
Telephone Number	:	731-664-9119
Fax Number	:	731-421-0425

Provider Business Practice Location Address
First Line	:	25 SECURITY DR
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-3626
Country	:	US
Telephone Number	:	731-664-9119
Fax Number	:	731-421-0425

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/08/2007

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Directions to “ LINDA LANEY LPC” Practice Location

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