Basic Information
| Provider Information | |||||||||
| NPI: | 1922739960 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LANEY | ||||||||
| FirstName: | BRIDGET | ||||||||
| MiddleName: | |||||||||
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| Credential: | LCSWA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 76 SMOKE RISE DR | ||||||||
| Address2: | |||||||||
| City: | MURPHY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 289067046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8285572706 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 750 W US HIGHWAY 64 | ||||||||
| Address2: | |||||||||
| City: | MURPHY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 289068115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8288370071 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2022 | ||||||||
| LastUpdateDate: | 07/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | P017945 | NC | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.