MEDICARE: JOSEPHINE LANGE

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	BBH-SWLC-LIC-80928	MT

General Provider Information

NPI Number	:	1609716331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPHINE LANGE

Provider Business Mailing Address
First Line	:	1001 S HIGGINS AVE
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59801-4146
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 S HIGGINS AVE
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59801-4146
Country	:	US
Telephone Number	:	406-214-3810
Fax Number	:

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

Provider Enumeration Date	:	03/31/2026
Last Update Date	:	04/08/2026

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Directions to “ JOSEPHINE LANGE ” Practice Location

Language	Start Address	Practice Location

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