Theodore W. Lane PHD, PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1264 Issued in NC

Legal business name

THEODORE W. LANE PHD, PLLC

Practice address

185 E New Hampshire Ave
Southern Pines, NC 28387-5529

Phone

(910) 692-9100

Fax

(910) 692-9109

NPI assigned

Apr 6, 2016

Last updated

Apr 6, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Theodore W Lane, PH.D.

Title

Sole Member

Phone

(910) 692-9100

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Deborah Kaye Rich, LCSW LPC MAC

  • Clinical Social Worker
  • Southern Pines, NC
  • NPI 1235124090
  NPD (past)

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459900800000",
    "number": "1427412360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 E NEW HAMPSHIRE AVE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875529",
            "telephone_number": "910-692-9100",
            "fax_number": "910-692-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 E NEW HAMPSHIRE AVE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875529",
            "telephone_number": "910-692-9100",
            "fax_number": "910-692-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODORE W. LANE PHD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-06",
        "last_updated": "2016-04-06",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "910-692-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "1264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rebecca Thienel

• Clinical Psychologist in Southern Pines, NC
• Providers in Southern Pines, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; 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.