Provider Demographics
NPI:1578814737
Name:LANIER, RONI JAY (MS, LPC, CDC I)
Entity Type:Individual
Prefix:MR
First Name:RONI
Middle Name:JAY
Last Name:LANIER
Suffix:
Gender:M
Credentials:MS, LPC, CDC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 141104
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99514-1104
Mailing Address - Country:US
Mailing Address - Phone:907-223-4374
Mailing Address - Fax:907-279-0069
Practice Address - Street 1:3505 E 19TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3404
Practice Address - Country:US
Practice Address - Phone:907-223-4374
Practice Address - Fax:907-279-0069
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-28
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3720101YA0400X
AK100058101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1578814737OtherNPI