Provider Demographics
NPI:1508928086
Name:LANE, THOMAS (LCSW)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:LANE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 MOUNT KEMBLE AVE
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-5155
Mailing Address - Country:US
Mailing Address - Phone:973-971-4695
Mailing Address - Fax:973-290-7614
Practice Address - Street 1:95 MOUNT KEMBLE AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-5155
Practice Address - Country:US
Practice Address - Phone:973-971-4695
Practice Address - Fax:973-290-7614
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC007009001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical