Provider Demographics
NPI:1629395942
Name:LANE, ROBIN RENEE (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:RENEE
Last Name:LANE
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:R
Other - Middle Name:RENEE
Other - Last Name:LANE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC, NCC
Mailing Address - Street 1:172 CARRINGTON LN
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28146-5201
Mailing Address - Country:US
Mailing Address - Phone:704-209-6066
Mailing Address - Fax:
Practice Address - Street 1:172 CARRINGTON LN
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28146-5201
Practice Address - Country:US
Practice Address - Phone:704-209-6066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-26
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4921101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional