Provider Demographics
NPI:1720801137
Name:LANGE, EMMA MAE (MSW, LSW, EMDR)
Entity type:Individual
Prefix:MS
First Name:EMMA
Middle Name:MAE
Last Name:LANGE
Suffix:
Gender:F
Credentials:MSW, LSW, EMDR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 BRADFORD LN
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-2610
Mailing Address - Country:US
Mailing Address - Phone:224-425-6387
Mailing Address - Fax:
Practice Address - Street 1:830 E HIGGINS RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4797
Practice Address - Country:US
Practice Address - Phone:847-592-5588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker