MARY LANE (NPI# 1215450234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215450234 |
| Entity Type | Individual |
| Full Name | MARY LANE |
| Credential | LISW |
| Practice Address |
430 Southgate Ave Iowa City IA 52240-4425 |
| Mailing Address |
1353 George W Brumley Way Se Atlanta GA 30317-1743 |
| Practice Telephone | 3193514357 |
| Mailing Telephone | 4043736614 |
| Mailing Fax Number | 4043732926 |
| Enumeration Date | 2017-07-21 |
| Last Update Date | 2020-09-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
CSW007041 | GA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 420946031 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295130839 | Mary Elizabeth Lane | Nurse Practitioner | 1350a Cleveland St, Greenville, SC 29607-2408 | 2014-10-24 |
| 1629237284 | Mary P Lane | Nurse Practitioner | Stony Brook Univ Med Ical Ctr, T12, 080 Health Science Center, Stony Brook, NY 11794-0001 | 2008-06-08 |
| 1871634683 | Mary Penfield Lane | Nurse Practitioner | 5369 Pineywood Rd, Birmingham, AL 35242-3424 | 2007-02-12 |
| 1487767091 | Mary Anne Lane | Registered Nurse | 340 Seminary St., Kenansville, NC 28349 | 2006-08-16 |
| 1033105291 | Mary Boggs Lane | Family Medicine | Cherokee County Health Department, 228 Hilton Street, Murphy, NC 28906-2814 | 2005-09-23 |
| 1649801614 | Mary Lane | Physical Therapist | 1854 W Auburn Rd Ste 200, Rochester Hills, MI 48309-3868 | 2020-01-29 |
| 1144871914 | Mary Margaret Lane | Social Worker | 500 Victory Rd, Quincy, MA 02171-3139 | 2019-09-24 |
| 1134778715 | Mary Patricia Lane | Behavior Technician | 925 Conference Dr, Greenville, NC 27858-5971 | 2019-09-06 |
| 1508366238 | Mary C Lane | Licensed Vocational Nurse | 11049 W Hoffman Dr, Odessa, TX 79764-9043 | 2018-02-19 |
| 1518470327 | Mary Alice Lane | Registered Nurse | 5231 Penn Ave, Pittsburgh, PA 15224-1768 | 2017-11-15 |
| Street Address |
430 SOUTHGATE AVE |
| City | IOWA CITY |
| State | IA |
| Zip Code | 52240-4425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588615355 | Prelude Behavioral Services | Community/Behavioral Health | 430 Southgate Ave, Iowa City, IA 52240-4425 | 2006-05-15 |
| 1760095061 | Carli Holub | Counselor | 430 Southgate Ave, Iowa City, IA 52240-4425 | 2020-08-26 |
| 1477165025 | Allie Nicole Rieken | Counselor | 430 Southgate Ave, Iowa City, IA 52240-4425 | 2020-08-17 |
| 1346858719 | Alison Clark | Counselor | 430 Southgate Ave, Iowa City, IA 52240-4425 | 2020-07-21 |
| 1811521651 | Jacob Livermore | Counselor | 430 Southgate Ave, Iowa City, IA 52240-4425 | 2020-03-02 |
| 1760026587 | Jacquelyne Chu | Counselor | 430 Southgate Ave, Iowa City, IA 52240-4425 | 2019-11-05 |
| 1417591785 | Eugenia Ann Dabney Hofammann | Counselor | 430 Southgate Ave, Iowa City, IA 52240-4425 | 2019-10-30 |
| 1558917500 | Zarah Elizabeth Roberts | Counselor | 430 Southgate Ave, Iowa City, IA 52240-4425 | 2019-08-15 |
| 1922652734 | Sarah Vining | Registered Nurse | 430 Southgate Ave, Iowa City, IA 52240-4425 | 2019-07-30 |
| 1275027633 | Kinsey Wohlers | Social Worker | 430 Southgate Ave, Iowa City, IA 52240-4425 | 2018-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215408703 | Huan-chung Scott Liu | Psychologist | 332 S Linn St Ste 14, Iowa City, IA 52240 | 2018-12-10 |
| 1124531579 | Amber Marie Wong | Counselor | 47 High Circle Drive, Iowa City, IA 52240 | 2017-11-08 |
| 1356852321 | Spencer Joseph Bohr | Specialist/Technologist | 314 S Governor St, Iowa City, IA 52240 | 2017-10-18 |
| 1992215651 | Kezia Jade Digioia | Student in an Organized Health Care Education/Training Program | 505 East Burlington St, Apt 7b, Iowa City, IA 52240 | 2017-10-09 |
| 1457879694 | Teleigha Teilon Lourell Starks | Specialist/Technologist | 629 South Johnson, 3, Iowa City, IA 52240 | 2017-09-08 |
| 1003213448 | National Seating & Mobility, Inc | Durable Medical Equipment & Medical Supplies | 2415 Heinz Rd Ste 1, Iowa City, IA 52240 | 2014-12-01 |
| 1750701439 | County of Johnson | Public Health or Welfare | 855 S Dubuque, Suite 217, Iowa City, IA 52240 | 2014-04-22 |
| 1083045892 | Julie Louise Gallagher | Dietitian, Registered | 1720 Waterfront Drive, Iowa City, IA 52240 | 2013-12-04 |
| 1619314515 | Jade A Baxley | Physical Therapist | 1130 Scott Blvd., Ste. 1, Iowa City, IA 52240 | 2013-05-31 |
| 1629316062 | Shelter House Community Shelter and Transition Services | Community/Behavioral Health | 429 Southgate Ave, Iowa City, IA 52240 | 2013-01-18 |
| Find all providers in zip 52240 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023624913 | Be Well Healing Services, LLC | Social Worker | 1226 Sunset St, Iowa City, IA 52246-4942 | 2020-09-16 |
| 1225662356 | Ricardo Charria | Social Worker | 1020 Kirkwood Ave, Iowa City, IA 52240-5739 | 2020-02-27 |
| 1053964098 | Lindsay L Kenyon | Social Worker | 3330 Lower West Branch Rd, Iowa City, IA 52245-4102 | 2019-07-18 |
| 1740792266 | Katherine Ann Donahue | Social Worker | 960 Longfellow Pl, Iowa City, IA 52240-6267 | 2017-10-25 |
| 1205360054 | Robert Otto | Social Worker | 520 10th Ave Ste B, Iowa City, IA 52241-1910 | 2017-04-19 |
| 1578017224 | Breanne Siebach | Social Worker | 200 Hawkins Dr # Gh124, Iowa City, IA 52242-1009 | 2016-08-11 |
| 1972962371 | Angeleah Korin Whitlatch | Social Worker | 100 Hawking Drive, Iowa City, IA 52242 | 2016-02-15 |
| 1922463769 | Holly Mohr | Social Worker | 2412 Towncrest Dr, Iowa City, IA 52240-6622 | 2015-12-21 |
| 1134509698 | Polly Porter | Social Worker | 1303 Carroll St, Iowa City, IA 52240-4677 | 2015-05-31 |
| 1316378060 | Sojourner Psychotherapy Plc | Social Worker | 300 Scott Ct, Iowa City, IA 52245-3951 | 2013-12-05 |
| Find all providers in IOWA CITY | ||||
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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.