Provider Demographics
NPI:1568186906
Name:BALABAN, LANE (LPC)
Entity Type:Individual
Prefix:
First Name:LANE
Middle Name:
Last Name:BALABAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5268 LOCKSLEY AVE APT A
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1091
Mailing Address - Country:US
Mailing Address - Phone:609-529-3163
Mailing Address - Fax:
Practice Address - Street 1:5268 LOCKSLEY AVE APT A
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1091
Practice Address - Country:US
Practice Address - Phone:609-529-3163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-29
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional