Healthcare Provider Details

I. General information

NPI: 1598020224
Provider Name (Legal Business Name): SUSAN E LANG LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2012
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 DOUGLAS AVE STE C
AMES IA
50010-6260
US

IV. Provider business mailing address

408 DOUGLAS AVE STE C
AMES IA
50010-6260
US

V. Phone/Fax

Practice location:
  • Phone: 515-233-6110
  • Fax:
Mailing address:
  • Phone: 515-233-6110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number001439
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: