MEDICARE: MR. JEFFREY LANG LPC

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	101YM0800X	Mental Health Counselor	LPC.0017372	CO

General Provider Information

NPI Number	:	1225966427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEFFREY LANG LPC

Provider Business Mailing Address
First Line	:	5485 CONESTOGA CT STE 100H
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80301-2752
Country	:	US
Telephone Number	:	720-773-1364
Fax Number	:

Provider Business Practice Location Address
First Line	:	5485 CONESTOGA CT STE 100H
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80301-2752
Country	:	US
Telephone Number	:	720-773-1364
Fax Number	:

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

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

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