Provider Demographics
NPI:1871796995
Name:LANEY, IRENE S (LADC)
Entity type:Individual
Prefix:MS
First Name:IRENE
Middle Name:S
Last Name:LANEY
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1156 SHORE RD
Mailing Address - Street 2:
Mailing Address - City:LAMOINE
Mailing Address - State:ME
Mailing Address - Zip Code:04605-4455
Mailing Address - Country:US
Mailing Address - Phone:207-667-3100
Mailing Address - Fax:
Practice Address - Street 1:5 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1932
Practice Address - Country:US
Practice Address - Phone:207-667-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC3832101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)