Individual provider Active NPI

Terry Alan Lane, LCSW

  • Clinical Social Worker
  • Sulphur, LA
National Provider Identifier
1003154113
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7327 Issued in LA
Practice address
700 1St Ave
Sulphur, LA 70663-3423
Phone
(337) 528-6969
Fax
(337) 528-6970
NPI assigned
Jan 24, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7327 LA Primary

Addresses

Primary practice location

700 1St Ave
Sulphur, LA 70663-3423

Mailing address

700 1St Ave
Sulphur, LA 70663-3423
Phone (337) 528-6969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150225002048 LA Practitioner - Clinical Social Worker 7517283120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7327LAMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1003154113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 1ST AVE",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706633423",
            "telephone_number": "337-528-6969",
            "fax_number": "337-528-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 1ST AVE",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706633423",
            "telephone_number": "337-528-6969",
            "fax_number": "337-528-6970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "TERRY",
        "middle_name": "ALAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-24",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "7327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sulphur, LA

Sources for this page

Verify at the official NPI Registry.