Provider Demographics
NPI:1710041389
Name:LAYNE, EUGENE G (LMHC,CRC)
Entity Type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:G
Last Name:LAYNE
Suffix:
Gender:M
Credentials:LMHC,CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 FIFTH AVE APT 37
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-1559
Mailing Address - Country:US
Mailing Address - Phone:718-881-7600
Mailing Address - Fax:914-740-3787
Practice Address - Street 1:21 FIFTH AVE APT 37
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NY
Practice Address - Zip Code:10803-1559
Practice Address - Country:US
Practice Address - Phone:718-881-7600
Practice Address - Fax:914-740-3787
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002665101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health