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Individual
LIAM R LANE
Active
Individual
LIAM R LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW, LADC-I
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
14701
MA
1041C0700X
Clinical Social Worker
Primary
126828
MA
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
08/12/2020
Last updated
02/18/2025
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