Ms Myia Cormichel Lane, LCSW is a
Social Worker - Clinical based in Gulfport, Mississippi. Ms Myia Cormichel Lane is licensed to practice in Mississippi (license number C11117) and her current practice location is
4605 Goldfinch Dr, Gulfport, Mississippi. She can be reached at her office (for appointments etc.) via phone at
(228) 219-5219.
NPI number for Ms Myia Cormichel Lane is 1831870815 and her current mailing address is 69 Holly Cir, Gulfport, Mississippi. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1831870815.
Healthcare Provider's Profile
| Full Name | Ms Myia Cormichel Lane |
|---|
| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 4605 Goldfinch Dr, Gulfport, Mississippi |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1831870815
- Provider Enumeration Date: 07/31/2023
- Last Update Date: 08/26/2024
Medical Identifiers
Medical identifiers for Ms Myia Cormichel Lane such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1831870815 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | M9748 (Mississippi) | Secondary |
| 1041C0700X | Social Worker - Clinical | C11117 (Mississippi) | 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. Ms Myia Cormichel 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 Address | Practice Location Address |
|---|
Ms Myia Cormichel Lane, LCSW
69 Holly Cir,
Gulfport, MS 39501-8629
Ph: (228) 219-5219 | Ms Myia Cormichel Lane, LCSW
4605 Goldfinch Dr,
Gulfport, MS 39501-7218
Ph: (228) 219-5219 |
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