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Individual
KELSEY LANGE
Active
Individual
KELSEY LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC LPCC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
305331
MN
101YM0800X
Mental Health Counselor
3501
MN
101YM0800X
Mental Health Counselor
Primary
CC03501
MN
Other
Enumeration date
08/10/2022
Last updated
11/29/2023
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