Provider Demographics
NPI:1073122636
Name:LANIER, ASHLEY (LCMHCA)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:LANIER
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2719 GRAVES DR STE 5
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-4536
Mailing Address - Country:US
Mailing Address - Phone:919-330-4367
Mailing Address - Fax:
Practice Address - Street 1:2719 GRAVES DR STE 5
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-4536
Practice Address - Country:US
Practice Address - Phone:919-330-4367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13896101YM0800X
NCA13896101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health