Leonard Wallace Lane Jr., MFT INTERN

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

76583 Issued in CA

Practice address

1926 Beverly Blvd
Los Angeles, CA 90057-2402

Phone

(213) 353-1140

Fax

(213) 353-1151

NPI assigned

Oct 30, 2017

Last updated

Oct 30, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509321600000",
    "number": "1770095879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1926 BEVERLY BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572402",
            "telephone_number": "213-353-1140",
            "fax_number": "213-353-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1926 BEVERLY BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572402",
            "telephone_number": "213-353-1140",
            "fax_number": "213-353-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "LEONARD",
        "middle_name": "WALLACE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MFT INTERN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-30",
        "last_updated": "2017-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "76583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connie J Lane, M.D.
• Dana Lane, COTA/L
• Darrell Charles Lane Jr.
• Kishma Lane
• Kyrstin Lynnice Lane
• Natasha Joanne Lane, LAC
• Phuong My Lane, BS
• Sharon Lane, REGISTERED COUNSELOR
• Brenda Lizeth Lanestoza Navarro
• Jeremy Vincent Laney, MD

• Mental Health Counselor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2017; 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.