Provider Demographics
NPI:1770640765
Name:MARKLANE, LTD.
Entity Type:Organization
Organization Name:MARKLANE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:DMIN
Authorized Official - Phone:804-740-1829
Mailing Address - Street 1:8401 PATTERSON AVE
Mailing Address - Street 2:SUITE G-102
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-6430
Mailing Address - Country:US
Mailing Address - Phone:804-740-1829
Mailing Address - Fax:
Practice Address - Street 1:8401 PATTERSON AVE
Practice Address - Street 2:SUITE G-102
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-6430
Practice Address - Country:US
Practice Address - Phone:804-740-1829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002355101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty