Individual provider Active NPI

Jean Elizabeth Lavane, LMFT

  • Marriage & Family Therapist
  • Albany, CA
National Provider Identifier
1649413345
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC45425 Issued in CA
Practice address
646 Cornell Ave
Albany, CA 94706-1211
Phone
(510) 550-2922
Fax
(510) 550-2922
NPI assigned
Apr 9, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC45425 CA Primary

Addresses

Primary practice location

646 Cornell Ave
Albany, CA 94706-1211

Mailing address

1831 Solano Avenue #7518
Berkeley, CA 94707
Phone (510) 550-2922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC45425CAMDMarriage & Family Therapist
45425CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1649413345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1831 SOLANO AVENUE #7518",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94707",
            "telephone_number": "510-550-2922",
            "fax_number": "510-550-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 CORNELL AVE",
            "city": "ALBANY",
            "state": "CA",
            "postal_code": "947061211",
            "telephone_number": "510-550-2922",
            "fax_number": "510-550-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVANE",
        "first_name": "JEAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-09",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC45425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, CA

Sources for this page

Verify at the official NPI Registry.