Provider Demographics
NPI:1124240148
Name:LANG, BARBARA JEAN (MAPC LISAC LCAC)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:JEAN
Last Name:LANG
Suffix:
Gender:F
Credentials:MAPC LISAC LCAC
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:JEAN
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MAPC LISAC LCAC
Mailing Address - Street 1:1668 E TREMAINE AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-8138
Mailing Address - Country:US
Mailing Address - Phone:480-710-8995
Mailing Address - Fax:
Practice Address - Street 1:1427 N 3RD ST # 130
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1605
Practice Address - Country:US
Practice Address - Phone:602-253-8488
Practice Address - Fax:602-253-8340
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor