Provider Demographics
NPI:1447866058
Name:ANDERSON, LANIE ANN
Entity type:Individual
Prefix:
First Name:LANIE
Middle Name:ANN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LANIE
Other - Middle Name:
Other - Last Name:MCKEEVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30 SIXTH STREET
Mailing Address - Street 2:
Mailing Address - City:ASHVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804
Mailing Address - Country:US
Mailing Address - Phone:512-983-3217
Mailing Address - Fax:
Practice Address - Street 1:30 SIXTH STREET
Practice Address - Street 2:
Practice Address - City:ASHVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804
Practice Address - Country:US
Practice Address - Phone:828-372-2646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-18
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA15835101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health