Active NPI
Lane Alexander Vance, LPC
- Mental Health Counselor
- Brooklyn, NY
National Provider Identifier
1467996157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 010210
- Practice address
- 946 Bushwick Ave Apt D2
Brooklyn, NY 11221-3765 - Phone
- (917) 887-2096
- NPI assigned
- Dec 14, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | APC005562 | GA | |
| Professional Counselor | 101YP2500X | LPC010993 | GA | |
| Mental Health Counselor | 101YM0800X | 010210 | NY | Primary |
Addresses
Primary practice location
946 Bushwick Ave Apt D2
Brooklyn, NY 11221-3765
Mailing address
946 Bushwick Ave Apt D2
Brooklyn, NY 11221-3765
Phone (917) 887-2096
Other practice location 1
1017 Fayetteville Rd SE
Ste. B
Atlanta, GA 30316-2932
Phone (770) 765-3340
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 |
|---|---|---|---|
| APC005562 | GA | MD | Counselor |
| LPC010993 | GA | MD | Professional Counselor |
| 010210 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585008000000",
"number": "1467996157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "946 BUSHWICK AVE APT D2",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112213765",
"telephone_number": "917-887-2096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "946 BUSHWICK AVE APT D2",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112213765",
"telephone_number": "917-887-2096"
}
],
"practiceLocations": [
{
"address_1": "1017 Fayetteville Rd SE",
"address_2": "Ste. B",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303162932",
"country_code": "US",
"telephone_number": "770-765-3340",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VANCE",
"first_name": "LANE",
"middle_name": "ALEXANDER",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-12-14",
"last_updated": "2020-03-24",
"certification_date": "2020-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "GA",
"license": "APC005562",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC010993",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "010210",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.