Individual
ABIGAIL ELAINE LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, CASAC
Contact information
Practice address
113 CHURCH ST, NORTH SYRACUSE, NY 13212-2370
(315) 415-0308
Mailing address
4141 BIRCHWOOD DR N, LIVERPOOL, NY 13090-2101
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
32842
NY
101YM0800X
Mental Health Counselor
Primary
010623-01
NY
Other
Enumeration date
02/01/2021
Last updated
02/01/2021
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