Provider Demographics
NPI:1902664808
Name:LANE, STEPHEN GREGORY (THM, BCC-HPC)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:GREGORY
Last Name:LANE
Suffix:
Gender:M
Credentials:THM, BCC-HPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 VETERANS MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-7445
Mailing Address - Country:US
Mailing Address - Phone:254-743-0991
Mailing Address - Fax:254-743-0523
Practice Address - Street 1:1901 VETERANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-7445
Practice Address - Country:US
Practice Address - Phone:254-743-0991
Practice Address - Fax:254-743-0523
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral