Provider Demographics
NPI:1881757045
Name:DAVID, LANCE ALAN (LCPC)
Entity type:Individual
Prefix:MR
First Name:LANCE
Middle Name:ALAN
Last Name:DAVID
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:277 PENINSULA FARM ROAD
Mailing Address - Street 2:STE I
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012
Mailing Address - Country:US
Mailing Address - Phone:410-315-8253
Mailing Address - Fax:410-315-8256
Practice Address - Street 1:277 PENINSULA FARM ROAD
Practice Address - Street 2:STE I BAYSHORE COUNSELING & PSYCHOLOGICAL SERVICES LLC
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012
Practice Address - Country:US
Practice Address - Phone:410-315-8253
Practice Address - Fax:410-315-8256
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDLC1883101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
64350201OtherBCBS OF MD