Provider Demographics
NPI:1386033959
Name:GRIFFITH, LANE KIMBERLY (MA, LCMHC, NCC)
Entity Type:Individual
Prefix:
First Name:LANE
Middle Name:KIMBERLY
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:MA, LCMHC, NCC
Other - Prefix:
Other - First Name:LANE
Other - Middle Name:KIMBERLY
Other - Last Name:HAWES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1403
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NC
Mailing Address - Zip Code:28658-1403
Mailing Address - Country:US
Mailing Address - Phone:828-465-1007
Mailing Address - Fax:828-465-6131
Practice Address - Street 1:22 S MAIN AVE
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NC
Practice Address - Zip Code:28658-3354
Practice Address - Country:US
Practice Address - Phone:828-465-1007
Practice Address - Fax:828-465-6131
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-20
Last Update Date:2021-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCSP II101YS0200X
NC8114101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional