Provider Demographics
NPI:1215180633
Name:LANGE, MATTHEW DEAN (LPC-MH)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:DEAN
Last Name:LANGE
Suffix:
Gender:
Credentials:LPC-MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 CHESTNUT PL APT 501
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-6327
Mailing Address - Country:US
Mailing Address - Phone:605-545-7690
Mailing Address - Fax:
Practice Address - Street 1:1770 CHESTNUT PL APT 501
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-6327
Practice Address - Country:US
Practice Address - Phone:605-545-7690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD2169101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health