MARY JANE LANE LMFT LLC (NPI# 1770147548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770147548 |
| Entity Type | Organization |
| Organization Name | MARY JANE LANE LMFT LLC |
| Practice Address |
412 S Clay Ave # 212 Kirkwood MO 63122-5860 |
| Practice Telephone | 3148052977 |
| Practice Fax Number | 3148229696 |
| Mailing Telephone | 3148052977 |
| Mailing Fax Number | 3148229696 |
| Enumeration Date | 2019-04-27 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | MARY JANE LANE (PROVIDER) |
| Authorized Official Telephone | 3148052947 |
| Authorized Official Credential | LPC LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Mary Jane Lane LMFT LLC | Doing Business As Name - Organization |
| Street Address |
412 S CLAY AVE # 212 |
| City | KIRKWOOD |
| State | MO |
| Zip Code | 63122-5860 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659933174 | Keela Rushing | Physical Therapist | 439 S Kirkwood Rd Ste 200, Kirkwood, MO 63122 | 2019-07-04 |
| 1730643461 | Kirkwood Family Dental | Dentist | 333 S Kirkwood Road, Suite 105, Kirkwood, MO 63122 | 2019-01-28 |
| 1477061166 | Total Access Urgent Care, PC | Clinic/Center | 2980 Dougherty Ferry Rd, Saint Louis, MO 63122 | 2018-01-16 |
| 1760933469 | Missouri Cvs Pharmacy, L.l.c | Durable Medical Equipment & Medical Supplies | 10820 Manchester Rd, Kirkwood, MO 63122 | 2016-10-18 |
| 1518321041 | M. Kathleen Blanchard | Counselor | 11042 Manchester Rd., Kirkwood, MO 63122 | 2016-04-11 |
| 1265801914 | Kim Grega | Counselor | 700 S Kirkwood Rd, Kirkwood, MO 63122 | 2015-09-23 |
| 1245617943 | Mark Edward Taylor | Dentist | 610 North Geyer, Kirkwood, MO 63122 | 2015-05-01 |
| 1467843094 | Mary Elizabeth Boomgarden | Physical Therapist | 9645 Big Bend Boulevard, Saint Louis, MO 63122 | 2015-02-18 |
| 1760725717 | Michael Diller Counseling | Counselor | 144 W Madison Avenue, Kirkwood, MO 63122 | 2013-03-28 |
| 1427309954 | Anne Marie Delaplain | Dentist | 725 Laclede Station Road, Webster Groves, MO 63122 | 2012-09-24 |
| Find all providers in zip 63122 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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|---|---|---|---|---|
| 1053953422 | Kirwood Medication Assisted Treatments | Clinic/Center | 111 Prospect Ave Ste 201, Kirkwood, MO 63122-6052 | 2019-10-17 |
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| 1366073546 | Awakened Life Healing, LLC | Clinic/Center | 10801 Big Bend Rd, Kirkwood, MO 63122-6055 | 2020-01-28 |
| 1811492077 | Roots Renewal Counseling | Clinic/Center | 11042 Manchester Rd, Kirkwood, MO 63122-1244 | 2018-03-28 |
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| 1982229498 | Rebecca Wallace Counseling LLC | Clinic/Center | 207 Peach Way, Suite 110, Columbia, MO 65203 | 2020-06-10 |
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| 1891329322 | Individual Marriage and Family Enrichment LLC | Clinic/Center | 601 W Nifong Blvd Ste 1e, Columbia, MO 65203-6804 | 2020-02-24 |
| 1861024754 | Chrysalis Wellness LLC | Clinic/Center | 3863 S Campbell Ave Ste A, Springfield, MO 65807-5339 | 2020-02-07 |
| 1275178451 | Awaken360, Inc. | Clinic/Center | 829 W Atlantic St, Springfield, MO 65803-1517 | 2019-11-12 |
| 1558921361 | Next Steps Therapy & Coaching, LLC | Clinic/Center | 1040 Fairgrounds Road, St. Charles, MO 63301 | 2019-06-14 |
| Find all providers with the same taxonomy | ||||
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| 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.