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NPI Code Detail

MEDICARE: MS. MARY CATHERINE LANGE LMSW

MEDICARE: MS. MARY CATHERINE LANGE LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6801078996MI

General Provider Information

NPI Number : 1912024936
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY CATHERINE LANGE LMSW
Provider Business Mailing Address
First Line : 4172 MOHAWK TRL
Second Line :
City : ADRIAN
State : MI
Zip : 49221-9329
Country : US
Telephone Number : 734-657-6220
Fax Number :
Provider Business Practice Location Address
First Line : 142 E MAUMEE ST
Second Line :
City : ADRIAN
State : MI
Zip : 49221-2735
Country : US
Telephone Number : 517-263-5810
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2007
Last Update Date : 09/07/2023

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Directions to “ MS. MARY CATHERINE LANGE LMSW” Practice Location

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