MEDICARE: BENJAMIN LANG MSW, LCSW / LISW

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
1	1041C0700X	Clinical Social Worker	I.2304887	OH
2	1041C0700X	Clinical Social Worker	32072	MD
3	1041C0700X	Clinical Social Worker	149.024895	IL

General Provider Information

NPI Number	:	1215794656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN LANG MSW, LCSW / LISW

Provider Business Mailing Address
First Line	:	233 E REDWOOD ST STE 901F
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21202-3788
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	233 E REDWOOD ST STE 901F
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21202-3788
Country	:	US
Telephone Number	:	667-217-2455
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2024
Last Update Date	:	11/26/2025

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