# LISA LANG LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952808701
- **Authorized official:** MS. LISA LANG MS, ATRL-BC (LICENSED PSYCHOTHERAPIST)
- **Authorized official phone:** (414) 702-2119

## Contact information

- **Practice address:** 14135 NORTH CEDARBURG ROAD, MEQUON, WI 53097
- **Practice address phone:** (414) 702-2324
- **Mailing address:** 2027 NORTH 71ST STREET, WAUWATOSA, WI 53213
- **Mailing address phone:** (414) 702-2119

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 51-036 | WI | — |
| 221700000X | Art Therapist | 51-036 | WI | Yes |

## Other

- **Enumeration date:** 04/09/2018
- **Last updated:** 04/09/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01-226 | ATCB BOARD CERTIFICATION \# | — |
| 01 | — | 1902985922 | INDIVIDUAL NPI \# | — |
| 05 | — | 40961100 | — | WI |
| 01 | — | 51-036 | PSYCHOTHERAPY LICENSE \# | WI |