Provider Demographics
NPI:1003945593
Name:LANE, MELISSA ANNE (LCMHC)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:ANNE
Last Name:LANE
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CRISPIN CT
Mailing Address - Street 2:SUITE D-203
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-8204
Mailing Address - Country:US
Mailing Address - Phone:828-250-3700
Mailing Address - Fax:828-250-3701
Practice Address - Street 1:10 CRISPIN CT STE 203D
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-8205
Practice Address - Country:US
Practice Address - Phone:828-250-3700
Practice Address - Fax:828-250-3701
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5412101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103573Medicaid