Provider Demographics
NPI:1811399553
Name:LANE FAMILY CONSULTANTS, PLLC
Entity Type:Organization
Organization Name:LANE FAMILY CONSULTANTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:304-677-9324
Mailing Address - Street 1:5862 OLD ELKINS RD
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-4903
Mailing Address - Country:US
Mailing Address - Phone:304-677-9324
Mailing Address - Fax:
Practice Address - Street 1:5862 OLD ELKINS RD
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201-4903
Practice Address - Country:US
Practice Address - Phone:304-677-9324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV23037538251B00000X, 251C00000X, 251S00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency