Provider Demographics
NPI:1033519160
Name:PRICE, LANESHA (LCSW-A)
Entity Type:Individual
Prefix:
First Name:LANESHA
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8801 J M KEYNES DR
Mailing Address - Street 2:SUITE 440
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-8436
Mailing Address - Country:US
Mailing Address - Phone:704-537-9551
Mailing Address - Fax:
Practice Address - Street 1:8801 J M KEYNES DR
Practice Address - Street 2:SUITE 440
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-8436
Practice Address - Country:US
Practice Address - Phone:704-537-9551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0091181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical