Kelly M Lane, LCPC
Counselor, Professional in Sedgwick, KS. Individual provider (NPI-1).
NPI number1124474119
StatusActive
Last updated in NPPESJul 22, 2024
Details
- NPI
- 1124474119
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Kelly M Lane
- Credential
- LCPC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 9, 2016
- Certification date
- Jul 22, 2024
- Last updated
- Jul 22, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 03759 | KS | Yes |
| 101YM0800X | Counselor, Mental Health | 2175 | KS |
Practice location
21910 W 113th St NSedgwick, KS 67135-9577
Phone 316-217-3865
Mailing address
21910 W 113th St NSedgwick, KS 67135-9577
Phone 316-217-3865
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