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Individual
NICHOLE LANGE
Active
Individual
NICHOLE LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD.0000866
CO
104100000X
Social Worker
LSW.0009920222
CO
1041C0700X
Clinical Social Worker
CSW.09924074
CO
1041C0700X
Clinical Social Worker
Primary
SW17221
FL
Other
Enumeration date
09/25/2013
Last updated
09/22/2020
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