Provider Demographics
NPI:1396730750
Name:LANEVE, JOHN ANTHONY JR (MSW LICSW)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ANTHONY
Last Name:LANEVE
Suffix:JR
Gender:M
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 REDIN DR
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-3120
Mailing Address - Country:US
Mailing Address - Phone:413-525-8701
Mailing Address - Fax:413-525-8728
Practice Address - Street 1:10 CRANE AVE
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-2360
Practice Address - Country:US
Practice Address - Phone:413-525-8701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1039361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP03206OtherBCBS
MA7304120OtherAETNA
MA1851641Medicaid
R42140Medicare UPIN
MAP03706Medicare ID - Type Unspecified