Provider Demographics
NPI:1811053150
Name:LANEY, MICHELE MARIE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:MARIE
Last Name:LANEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7236 FORESTVIEW LN N
Mailing Address - Street 2:SUITE 3205
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-5501
Mailing Address - Country:US
Mailing Address - Phone:612-419-8461
Mailing Address - Fax:763-425-6597
Practice Address - Street 1:7236 FORESTVIEW LN N
Practice Address - Street 2:SUITE 3205
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-5501
Practice Address - Country:US
Practice Address - Phone:612-419-8461
Practice Address - Fax:763-425-6597
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1188106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP 43552OtherHEALTHPARTNERS
MN693 G0AJOtherBLUE CROSS BLUE SHIELD