Individual
MR. MICAH GRANT LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
6400 S LEWIS AVE STE 100, TULSA, OK 74136-1019
(405) 378-2727
Mailing address
6400 S LEWIS AVE STE 100, TULSA, OK 74136-1019
(405) 378-2727
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC05479
OK
Other
Enumeration date
04/28/2010
Last updated
07/22/2025
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