Healthcare Provider Details

I. General information

NPI: 1912245879
Provider Name (Legal Business Name): ANNEMARIE KILLIAN LANGE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2013
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

967 E SWEDESFORD RD
EXTON PA
19341-2332
US

IV. Provider business mailing address

782 W PHILIP DR
PHOENIXVILLE PA
19460-2546
US

V. Phone/Fax

Practice location:
  • Phone: 484-678-7565
  • Fax:
Mailing address:
  • Phone: 484-678-7565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC006763
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: