Individual
ADAM J LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAADC
Contact information
Practice address
8633 KNOTT AVE, BUENA PARK, CA 90620-3852
(714) 527-6561
Mailing address
6355 EMBER AVE FL USA, COCOA, FL 32927-2429
(480) 862-6033
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
13290
AZ
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LR05270519
CA
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
10/19/2018
Last updated
08/30/2021
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