Provider Demographics
NPI:1831748409
Name:CHRISTINE LANE COUNSELING
Entity type:Organization
Organization Name:CHRISTINE LANE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-412-9978
Mailing Address - Street 1:9723 ACQUA CT UNIT 337
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34113-8155
Mailing Address - Country:US
Mailing Address - Phone:609-412-9978
Mailing Address - Fax:
Practice Address - Street 1:365 FIFTH AVE S
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6575
Practice Address - Country:US
Practice Address - Phone:239-234-2598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty