Provider Demographics
NPI:1467103234
Name:LANE, ALLYSON (LPC ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:
Last Name:LANE
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 RESACA BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738-5378
Mailing Address - Country:US
Mailing Address - Phone:713-805-0079
Mailing Address - Fax:
Practice Address - Street 1:311 RANCH ROAD 620 S STE 103
Practice Address - Street 2:
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-4747
Practice Address - Country:US
Practice Address - Phone:512-263-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional