Individual provider · Type 1 NPI

Lane Gormley, LPC

Professional Counselor · Kennesaw, GA

NPI number 1356677504 Active

Practice location

1050 Shiloh Rd NW, Suite 316
Kennesaw, GA 30144-7194

Mailing address

2575 Peachtree Rd NE, Unit 23A
Atlanta, GA 30305-3694

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XLPC005090 (GA)
Mental Health Counselor 101YM0800XLPC005090 (GA)
Professional Counselor Primary 101YP2500XLPC005090 (GA)

Professional Counselor: Definition to come...

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About NPI 1356677504

Lane Gormley, LPC's National Provider Identifier is 1356677504, issued on Oct 22, 2009. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Kennesaw, GA. The record was last updated on Oct 22, 2009.