Provider Demographics
NPI:1306362231
Name:LANE, SARAH RENEE (CADC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:RENEE
Last Name:LANE
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 720
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:ME
Mailing Address - Zip Code:04217-0720
Mailing Address - Country:US
Mailing Address - Phone:207-357-4400
Mailing Address - Fax:
Practice Address - Street 1:17 GARY ST
Practice Address - Street 2:
Practice Address - City:SOUTH PARIS
Practice Address - State:ME
Practice Address - Zip Code:04281-1636
Practice Address - Country:US
Practice Address - Phone:207-739-7001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)