David Ballard Lane Jr., LMSW, LLP, LPC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301003884 Issued in MI

Practice address

1199 Harris Ave
Tawas City, MI 48763-9681

Phone

(989) 362-8636

NPI assigned

Feb 8, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Ausable Valley CMH

  • Clinic/Center
  • Tawas City, MI
  • NPI 1952628893
  NPD (past)
• Ausable Valley Community Mental Health Services Board

  • Community/Behavioral Health Agency
  • Tawas City, MI
  • NPI 1417011701
  NPD (past)

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1356481014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 DOUGLAS DR",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487639422",
            "telephone_number": "989-362-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 HARRIS AVE",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487639681",
            "telephone_number": "989-362-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "DAVID",
        "middle_name": "BALLARD",
        "name_suffix": "Jr.",
        "credential": "LMSW, LLP, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401000213",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301003884",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801016231",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "6401000213",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LLP",
            "identifier": "6301003884",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMSW",
            "identifier": "6801016231",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kalee Koronka, MA, LPC
• Charles Edward Kudwa, DDS
• Nancy Elaine Laidlaw, AUD
• Lakeview Manor Acquisition Company, Inc.
• Christopher Russell Landrey, DO
• Melissa Loraine Lane, LLP
• Sydney Simpson Larsen, MA, LPC, CADC,
• Melissa Lavigne, RN
• Keith Lawrence
• Ronald John Leclair, D.C.

• Psychologist in Tawas City, MI
• Providers in Tawas City, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.