Provider Demographics
NPI:1003399114
Name:TESSENEER, LANE CASSIDY (LCSWA)
Entity type:Individual
Prefix:
First Name:LANE
Middle Name:CASSIDY
Last Name:TESSENEER
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-4358
Mailing Address - Country:US
Mailing Address - Phone:704-174-1900
Mailing Address - Fax:
Practice Address - Street 1:445 EARL RD
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-6700
Practice Address - Country:US
Practice Address - Phone:704-284-7008
Practice Address - Fax:704-751-3001
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical