Active NPI
Laney Dezanet
- Professional Counselor
- Augusta, GA
National Provider Identifier
1114769866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC016132
- Practice address
- 3643 Walton Way Ext BLDG 4
Augusta, GA 30909-6677 - Phone
- (706) 364-1404
- NPI assigned
- Jun 12, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC016132 | GA | Primary |
Addresses
Primary practice location
3643 Walton Way Ext BLDG 4
Augusta, GA 30909-6677
Mailing address
3643 Walton Way Ext BLDG 4
Augusta, GA 30909-6677
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC016132 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762732800000",
"number": "1114769866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3643 WALTON WAY EXT BLDG 4",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309096677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3643 WALTON WAY EXT BLDG 4",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309096677",
"telephone_number": "706-364-1404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEZANET",
"first_name": "LANEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-12",
"last_updated": "2025-11-10",
"certification_date": "2025-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC016132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.