Provider Demographics
NPI:1992088249
Name:LANG, JENNIFER E (MSW, LICSW)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:E
Last Name:LANG
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 OLD PINE RD
Mailing Address - Street 2:
Mailing Address - City:NARRAGANSETT
Mailing Address - State:RI
Mailing Address - Zip Code:02882-2408
Mailing Address - Country:US
Mailing Address - Phone:401-447-2074
Mailing Address - Fax:
Practice Address - Street 1:8 OLD PINE RD
Practice Address - Street 2:
Practice Address - City:NARRAGANSETT
Practice Address - State:RI
Practice Address - Zip Code:02882-2408
Practice Address - Country:US
Practice Address - Phone:401-447-2074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW021711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical