MR. WILLIAM BRADFORD LANE JR. (NPI# 1124542147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124542147 |
| Entity Type | Individual |
| Full Name | MR. WILLIAM BRADFORD LANE JR. |
| Credential | LPC |
| Practice Address |
409 Washington Ave Pocatello ID 83201-4520 |
| Practice Telephone | (208) 234-2646 |
| Mailing Telephone | 2082342646 |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2017-08-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | LPC-6550 | ID | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 1619177797 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730794751 | William Jay Lane | In Home Supportive Care | 410 Westgate Dr Unit A, Cleves, OH 45002-1144 | 2020-09-15 |
| 1952422966 | William Michael Lane | Dentist | 208 N Haddon Ave, Haddonfield, NJ 08033-2323 | 2007-04-03 |
| 1962420646 | William Blake Lane | Dentist | 6440 Bradley Park Dr, Columbus, GA 31904-3082 | 2006-07-18 |
| 1942246772 | William Henry Lane | Family Medicine | 2006 Shaw Ave, Clovis, CA 93611-4192 | 2006-06-21 |
| 1417581729 | William Lane | Behavior Technician | 27777 Inkster Rd Ste 100, Farmington Hills, MI 48334-5326 | 2020-02-25 |
| 1548752058 | William Lane | Counselor | 3840 Hulen St, Fort Worth, TX 76107-7277 | 2018-05-31 |
| 1366805558 | William Edward Lane | Student in an Organized Health Care Education/Training Program | 2301 Erwin Rd, Durham, NC 27705-4699 | 2016-04-04 |
| 1356700595 | William Lane | Home Health Aide | 1810 N Main St, Sumter, SC 29153-8688 | 2016-02-16 |
| 1386084374 | William C Lane IIi | Behavioral Analyst | 5135 Camino Al Norte, Suite 255, North Las Vegas, NV 89031-2387 | 2013-07-05 |
| 1528326428 | William Mcneely Lane | Dentist | 30 Resnik Rd, Plymouth, MA 02360-7211 | 2012-04-27 |
| Street Address |
409 WASHINGTON AVE |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-4520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619177797 | Bright Tomorrows Child Advocacy Center | Counselor | 409 Washington Ave, Pocatello, ID 83201-4520 | 2007-07-18 |
| 1073125605 | Laura Wolter | Counselor | 409 Washington Ave, Pocatello, ID 83201-4520 | 2020-08-17 |
| 1285110999 | Nicole Daniels | Counselor | 409 Washington Ave, Pocatello, ID 83201-4520 | 2018-07-16 |
| 1699287672 | Alyssa J. Brook | Counselor | 409 Washington Ave, Pocatello, ID 83201-4520 | 2017-10-30 |
| 1720366693 | Amanda Jo Minor | Counselor | 409 Washington Ave, Pocatello, ID 83201-4520 | 2011-07-26 |
| 1457582173 | Anne Tierney | Counselor | 409 Washington Ave, Pocatello, ID 83201-4520 | 2009-07-29 |
| 1346421120 | Brooks Bastian Hanks | Counselor | 409 Washington Ave, Pocatello, ID 83201-4520 | 2007-11-20 |
| 1003097437 | Dedra Christine Sanna | Counselor | 409 Washington Ave, Pocatello, ID 83201-4520 | 2007-11-14 |
| 1013198415 | Cassidy Michelle Roske | Counselor | 409 Washington Ave, Pocatello, ID 83201-4520 | 2007-11-14 |
| 1194904920 | Katherine Ann Downes | Counselor | 409 Washington Ave, Pocatello, ID 83201-4520 | 2007-10-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
| 1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
| 1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
| 1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
| 1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
| 1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
| 1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
| 1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
| 1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
| 1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
| Find all providers in zip 83201 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588202907 | Brianna Dannielle Windhorst | Counselor | 611 Wilson Ave Ste 5, Pocatello, ID 83201-5046 | 2019-12-16 |
| 1417598384 | Barton Vandenburg | Counselor | 1001 N 7th Ave, Pocatello, ID 83201-5761 | 2019-10-02 |
| 1689163867 | Sarah Nicolle Baquet | Counselor | 224 S Arthur Ave # 2, Pocatello, ID 83204-3202 | 2018-05-03 |
| 1750803110 | David Tim Williams | Counselor | 224 S. Arthur Suite 2, Pocatello, ID 83204 | 2017-07-07 |
| 1730437500 | Jeremy Garth Coleman | Counselor | 1246 Yellowstone Ave Ste F, Pocatello, ID 83201-4374 | 2012-08-27 |
| 1255602983 | Covey LLC | Counselor | 730 E Clark St # 4571, Pocatello, ID 83201-6238 | 2012-01-26 |
| 1427337831 | Justice Isaacson | Counselor | Cognitive Restructuring LLC, 707 North 7th Ave Ste #d, Pocatello, ID 83201-3357 | 2011-08-16 |
| 1700165628 | Connie Kreizenbeck | Counselor | 409 Washington Ave., Pocatello, ID 83201 | 2011-08-09 |
| 1740568658 | Kimberly B Rasmussen | Counselor | 231 N 6th, Pocatello, ID 83201 | 2011-07-26 |
| 1699005132 | Gina H Judd | Counselor | 819 N 12th Ave, Pocatello, ID 83201-4741 | 2010-01-06 |
| Find all providers in POCATELLO | ||||
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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.