Vicki L Lane, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY-005255 Issued in AZ

Practice address

1600 W Chandler Blvd Ste 110
Chandler, AZ 85224-6100

Phone

(415) 296-5290

Fax

(415) 296-5299

NPI assigned

Nov 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN, AZ2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbh.vickilane@140099.advancedmd-direct.com

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.

• Pacific Coast Psychiatric Associates Inc

  • Clinical Psychologist
  • Scottsdale, AZ
  • NPI 1023125465
  Medicare reassignment NPD
• Midwest Behavioral Health LLC

  • Psychiatry Physician
  • Evansville, IN
  • NPI 1427362201

  Psychologist

  Medicare reassignment NPD
• Psychology Specialists LTD

  • Clinical Psychologist
  • Las Vegas, NV
  • NPI 1003473448
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1265509897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 E INDIANA ST STE 103",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477157448",
            "telephone_number": "812-473-0181",
            "fax_number": "812-473-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W CHANDLER BLVD STE 110",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246100",
            "telephone_number": "415-296-5290",
            "fax_number": "415-296-5299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7300 E Indiana St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477157448",
            "country_code": "US",
            "telephone_number": "812-473-0181",
            "fax_number": "812-473-5822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANE",
        "first_name": "VICKI",
        "middle_name": "L",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20040842A",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "PSY-005255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000247634",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100437960",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Landmark Medical LLC
• Sara Rose Landwehr, PHARMD.
• Kiera Lane, N.M.D.
• Merrill Lane, LPC
• Valerie Anne Lane, P.T.
• Robert F Laney, M.D.
• Lang Lang Chang
• Jessica Lang, FNP-C
• Marshall Langan
• Stephanie Davis Langdon, CPO

• Psychologist in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.