Provider Demographics
NPI:1396244075
Name:LANGE, KAREN A
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:LANGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15290 E 6TH AVE UNIT 160
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-3453
Mailing Address - Country:US
Mailing Address - Phone:303-699-8181
Mailing Address - Fax:303-699-7968
Practice Address - Street 1:15290 E 6TH AVE UNIT 160
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-3453
Practice Address - Country:US
Practice Address - Phone:303-699-8181
Practice Address - Fax:303-699-7968
Is Sole Proprietor?:No
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC0105288101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor