Individual
ELISE JORGENSEN LANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW, LCAS, LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1268
NC
1041C0700X
Clinical Social Worker
Primary
10644
SC
1041C0700X
Clinical Social Worker
C007429
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SW1191
—
SC
Enumeration date
04/08/2008
Last updated
09/23/2020
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