Individual provider Active NPI

Abigail Elaine Lane, LMHC, CASAC

  • Mental Health Counselor
  • North Syracuse, NY
National Provider Identifier
1558952663
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
010623-01 Issued in NY
Practice address
113 Church St
North Syracuse, NY 13212-2370
Phone
(315) 415-0308
NPI assigned
Feb 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 32842 NY
Mental Health Counselor 101YM0800X 010623-01 NY Primary

Addresses

Primary practice location

113 Church St
North Syracuse, NY 13212-2370

Mailing address

4141 Birchwood Dr N
Liverpool, NY 13090-2101

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

LicenseStateTypeSpecialty
32842NYMDAddiction (Substance Use Disorder) Counselor
010623-01NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Branches of Growth Mental Health Counseling, PLLC Mental Health CurrentSince Feb 7, 2021 Accepting new patients
Branches of Growth, LLC Mental Health CurrentSince Feb 7, 2021 Accepting new patients

Locations

113 Church St
North Syracuse, NY 13212
Phone (315) 308-1062

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1558952663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 BIRCHWOOD DR N",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130902101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 CHURCH ST",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132122370",
            "telephone_number": "315-415-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "ABIGAIL",
        "middle_name": "ELAINE",
        "credential": "LMHC, CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-01",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "32842",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "010623-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; 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.