Individual
JESSICA D LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC-S, LICDC-CS
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.161705
OH
101YP2500X
Professional Counselor
C.1801141
OH
101YP2500X
Professional Counselor
Primary
E.2001904
OH
101YP2500X
Professional Counselor
Primary
E.2001904-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0309523
—
OH
01
—
14973982
CAQH
—
Enumeration date
08/22/2018
Last updated
07/16/2026
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