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General NPI Number Information
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NPI Number | 1215228309
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Entity Type | Individual
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Provider Name | MICHELLE A LANG LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/25/2011
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Last Update Date | 04/20/2021
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Provider Practice Location Address
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Address Line | 325 N END AVE APT. 16-Q
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City | NEW YORK
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State | NY
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Zip | 10282-1026
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Country | US
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Telephone | 212-273-6238
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Fax |
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Provider Business Mailing Address
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Address Line | 101 W 12TH ST APT 15T
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City | NEW YORK
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State | NY
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Zip | 10011-8129
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Country | US
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Telephone | 845-649-6520
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 083032
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License Number State | NY
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