THEODORE W. LANE (NPI# 1023156932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023156932 |
| Entity Type | Individual |
| Full Name | THEODORE W. LANE |
| Credential | PH.D. |
| Practice Address |
1540 Purdue Dr Ste 200 Fayetteville NC 28303-5510 |
| Mailing Address |
1100 E Connecticut Ave Southern Pines NC 28387-6719 |
| Practice Telephone | 9108678889 |
| Practice Fax Number | 9104873061 |
| Mailing Telephone | 9106924624 |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
1264 | NC | Behavioral Health & Social Service Providers |
| Street Address |
1540 PURDUE DR STE 200 |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28303-5510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053339283 | Deitra Letrice Williams-toone | Anesthesiology | 1540 Purdue Dr Ste 200, Fayetteville, NC 28303-5510 | 2006-07-17 |
| 1194225490 | Caroline Miller Harris | Physical Medicine & Rehabilitation | 1540 Purdue Dr Ste 200, Fayetteville, NC 28303-5510 | 2018-02-14 |
| 1437373578 | Cardinal Clinic, LLC | Psychiatry & Neurology | 1540 Purdue Dr Ste 200, Fayetteville, NC 28303-5510 | 2007-04-12 |
| 1659419430 | Aaron Melvin | Social Worker | 1540 Purdue Dr Ste 200, Fayetteville, NC 28303-5510 | 2007-02-02 |
| 1609925668 | Cardinal Clinic LLC | Counselor | 1540 Purdue Dr Ste 200, Fayetteville, NC 28303-5510 | 2007-01-09 |
| 1982761250 | Cardinal Clinic LLC | Counselor | 1540 Purdue Dr Ste 200, Fayetteville, NC 28303-5510 | 2007-01-03 |
| 1700967395 | Cardinal Clinic L.L.C. | Counselor | 1540 Purdue Dr Ste 200, Fayetteville, NC 28303-5510 | 2006-10-18 |
| 1679653588 | Brenda M. Dixon | Counselor | 1540 Purdue Dr Ste 200, Fayetteville, NC 28303-5510 | 2006-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404496 | Matthew Pace | Physician Assistant | Bldg 5-4257 Bastogne St, Fort Bragg, NC 28303 | 2020-07-20 |
| 1952920449 | Vonetta Bethea Jackson | Social Worker | 391 Wagoner Drive, Fayetteville, NC 28303 | 2020-04-14 |
| 1932746229 | Julie Harriss | Specialist/Technologist | Bldg E 4062, Canopy Lane, Fort Bragg, NC 28303 | 2019-12-05 |
| 1235780354 | Helen Delores Johnson | Technician | 261 Pierron Dr, Fayetteville, NC 28303 | 2019-09-20 |
| 1922655075 | Andrea Margaret Hutnam | Technician | 714 Shortridge Rd, Fayetteville, NC 28303 | 2019-08-23 |
| 1225695273 | Breona Lister | Dental Hygienist | 38 17 Gruber Rd, Fort Bragg, NC 28303 | 2019-05-24 |
| 1780148957 | Brian K Cox Sr. | Occupational Therapy Assistant | 5300 Ramsey St, Fayetteville, NC 28303 | 2019-01-22 |
| 1730670902 | Michael Sadtler | Counselor | 804 Stamper Rd Ste 101, Fayetteville, NC 28303 | 2018-05-23 |
| 1104320399 | Tia Porterfield | Counselor | 2018 Fort Bragg Rd Ste 112a, Fayetteville, NC 28303 | 2018-03-21 |
| 1154835577 | Jessica Bass Bosworth | Psychologist | 3415 Youngstown Dr, Fayetteville, NC 28303 | 2017-11-21 |
| Find all providers in zip 28303 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154969657 | Kathleen Ratcliff Andrews | Psychologist | 2300 Ramsey St # B51t, Fayetteville, NC 28301-3856 | 2019-12-16 |
| 1740757731 | Dia Boutwell | Psychologist | 125 Howard Ln Ste B, Fayetteville, GA 30215-1853 | 2018-10-27 |
| 1265950034 | Elizabeth Chaisson | Psychologist | 1 W Mountain St Ste 307, Fayetteville, AR 72701-6068 | 2017-08-31 |
| 1922470020 | Savanna Cloer Mccain Phd, Pa | Psychologist | 4257 N Gabel Dr # 2b, Fayetteville, AR 72703-5004 | 2015-10-28 |
| 1538578992 | Nicole Dreiling | Psychologist | 351 Wagoner Dr Ste 130, Fayetteville, NC 28303-4669 | 2014-08-10 |
| 1255627717 | Colleen Quinn | Psychologist | 200 Mason St, 2nd Floor, Fayetteville, NC 28301-5041 | 2011-06-23 |
| 1518278373 | Ingrid Jacobs | Psychologist | 1 E Center St Ste 333, Fayetteville, AR 72701-5349 | 2010-06-27 |
| 1427372119 | Sandra V Heinsz | Psychologist | 290 Ashborough Park, Fayetteville, GA 30215-6514 | 2010-03-24 |
| 1134361546 | Elizabeth E Knowles, Ph.d., Pa | Psychologist | 4241 N Gabel Dr, Fayetteville, AR 72703-5004 | 2009-03-31 |
| 1982846671 | Louis P. Anderson | Psychologist | 120 Michael Ct, Fayetteville, GA 30215-1846 | 2009-03-27 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28303 |
Please comment or provide details below to improve the information on THEODORE W. LANE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.