Provider Demographics
NPI:1194428763
Name:LANE, BRITTNEY (MHC-LIMITED PERMIT)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:LANE
Suffix:
Gender:F
Credentials:MHC-LIMITED PERMIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:HALFMOON
Mailing Address - State:NY
Mailing Address - Zip Code:12065-8612
Mailing Address - Country:US
Mailing Address - Phone:518-400-2783
Mailing Address - Fax:
Practice Address - Street 1:7 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:HALFMOON
Practice Address - State:NY
Practice Address - Zip Code:12065-8612
Practice Address - Country:US
Practice Address - Phone:518-400-2783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-23
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health