Individual provider Active NPI

Alexander Bailey Lane, LCSW

  • Clinical Social Worker
  • Lakeland, FL
National Provider Identifier
1104058569
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14232 Issued in FL
Practice address
2033 E Edgewood Dr Ste 4
Lakeland, FL 33803-3660
Phone
(638) 606-8097
NPI assigned
Aug 19, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X SW14232 FL Primary

Addresses

Primary practice location

2033 E Edgewood Dr Ste 4
Lakeland, FL 33803-3660

Mailing address

620 W Shady LN
Lakeland, FL 33803-2052
Phone (207) 347-9904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW14232FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Heal, LLC Clinical Current Accepting new patients

Locations

2033 E Edgewood Dr
Ste 4
Lakeland, FL 33803
Phone (863) 255-0297

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1250640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1104058569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W SHADY LN",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338032052",
            "telephone_number": "207-347-9904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2033 E EDGEWOOD DR STE 4",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338033660",
            "telephone_number": "638-606-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "ALEXANDER",
        "middle_name": "BAILEY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-19",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.