Provider Demographics
NPI:1417069469
Name:MCELANEY, LANCE MICHAEL (LICSW)
Entity Type:Individual
Prefix:
First Name:LANCE
Middle Name:MICHAEL
Last Name:MCELANEY
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 PERCIVAL DR
Mailing Address - Street 2:
Mailing Address - City:WEST BARNSTABLE
Mailing Address - State:MA
Mailing Address - Zip Code:02668
Mailing Address - Country:US
Mailing Address - Phone:508-362-0281
Mailing Address - Fax:
Practice Address - Street 1:62 DERBY ST
Practice Address - Street 2:STE 13
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043
Practice Address - Country:US
Practice Address - Phone:781-749-4600
Practice Address - Fax:781-741-8341
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1032821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA705727OtherTUFTS HEALTH PLAN
MA4594399OtherAETNA
MA04343088013OtherPACIFICARE BEHAVIORAL HEA
MAMEP01585OtherBCBS
MA4594399OtherAETNA