Individual
NICHOLAS MARK LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC/LMFT
Contact information
Practice address
6255 28TH ST. SE, SUITE 3, OFFICES C&D, GRAND RAPIDS, MI 49546
(231) 286-2355
Mailing address
599 OAK MEADOW DR, MIDDLEVILLE, MI 49333-8478
(231) 286-2355
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401018602
MI
106H00000X
Marriage & Family Therapist
4101007011
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1715928
—
MI
Enumeration date
01/11/2018
Last updated
08/24/2023
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