William Bradford Lane Jr., LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LPC-6550 Issued in ID

Practice address

409 Washington Ave
Pocatello, ID 83201-4520

Phone

(208) 234-2646

NPI assigned

Aug 1, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bright Tomorrows Child Advocacy Center

  • Case Management Agency
  • Pocatello, ID
  • NPI 1174876205
  NPD (past)
• Bright Tomorrows, Incorporated

  • Adolescent and Children Mental Health Clinic/Center
  • Pocatello, ID
  • NPI 1619177797

  Counselor

  NPD (past)

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124542147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 WASHINGTON AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014520",
            "telephone_number": "208-234-2646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 WASHINGTON AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014520",
            "telephone_number": "208-234-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "WILLIAM",
        "middle_name": "BRADFORD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ID",
            "license": "LPC-6550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619177797",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Lee Lance, SLP
• Brian Land
• Adam Landon, FNP-C
• Brelan J Lane, DPT
• Whitney Ann Lane
• Cynthia L Lange, LPC
• Bryan Lankford, LPC
• Chasen Larinto
• Larsen Dental Care
• Larsen Dental Care

• All providers in Pocatello, ID
• Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.