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NPI Code Detail

MEDICARE: MS. LANA ANN DREYFUSS LPCC LCADC LPC HTR

MEDICARE: MS. LANA ANN DREYFUSS LPCC LCADC LPC HTR
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
1103TC1900XCounseling PsychologistLCA1586MD
2103TC1900XCounseling PsychologistPC008271PA
3103TC1900XCounseling PsychologistLPCC11223CA

General Provider Information

NPI Number : 1679914428
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LANA ANN DREYFUSS LPCC LCADC LPC HTR
Provider Business Mailing Address
First Line : 1600 WEEOT WAY
Second Line :
City : ARCATA
State : CA
Zip : 95521-4734
Country : US
Telephone Number : 707-825-5000
Fax Number : 707-825-6747
Provider Business Practice Location Address
First Line : 501 N INDIAN RD
Second Line :
City : SMITH RIVER
State : CA
Zip : 95567-9509
Country : US
Telephone Number : 707-487-0215
Fax Number : 707-487-3003
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2013
Last Update Date : 07/19/2023

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