Individual
CAROLINE M LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW-ACP, QMHP, CSAC
Contact information
Practice address
3322 WESTERN BRANCH BLVD STE A, CHESAPEAKE, VA 23321-5142
(757) 673-3644
(757) 337-0165
Mailing address
PO BOX 54, MOYOCK, NC 27958-0054
(757) 716-8364
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
VA
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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