Provider Demographics
NPI:1033284542
Name:LANE, MILDRED D (EDD, NCC, LPC)
Entity Type:Individual
Prefix:DR
First Name:MILDRED
Middle Name:D
Last Name:LANE
Suffix:
Gender:F
Credentials:EDD, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 SAPLING DR
Mailing Address - Street 2:
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-4020
Mailing Address - Country:US
Mailing Address - Phone:412-486-1785
Mailing Address - Fax:412-396-1340
Practice Address - Street 1:5000 MCKNIGHT RD
Practice Address - Street 2:SUITE 305
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-3420
Practice Address - Country:US
Practice Address - Phone:412-486-1785
Practice Address - Fax:412-396-4159
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000357101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional