Theodore W Lane, PHD - Psychologist in Fayetteville, NC

Theodore W Lane, PHD is a Psychologist - Clinical based in Fayetteville, North Carolina. Theodore W Lane is licensed to practice in North Carolina (license number 1264) and his current practice location is 1540 Purdue Dr Ste 200, Fayetteville, North Carolina. He can be reached at his office (for appointments etc.) via phone at (910) 867-8889.

NPI number for Theodore W Lane is 1023156932 and his current mailing address is 1100 E Connecticut Ave, Southern Pines, North Carolina. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1023156932.

Contact Information

Theodore W Lane, PHD
1540 Purdue Dr Ste 200,
Fayetteville, NC 28303-5510
(910) 867-8889
(910) 487-3061

Map and Direction




Healthcare Provider's Profile

Full NameTheodore W Lane
GenderMale
SpecialityPsychologist - Clinical
Location1540 Purdue Dr Ste 200, Fayetteville, North Carolina
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1023156932
  • Provider Enumeration Date: 02/02/2007
  • Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Theodore W Lane such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1023156932NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical 1264 (North Carolina)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Theodore W Lane is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Theodore W Lane, PHD
1100 E Connecticut Ave,
Southern Pines, NC 28387-6719

Ph: (910) 692-4624
Theodore W Lane, PHD
1540 Purdue Dr Ste 200,
Fayetteville, NC 28303-5510

Ph: (910) 867-8889

Reviews and Comments


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