Individual
MS. STACY LEE LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW,LCSW,CADCII
Contact information
Practice address
15100 BOONES FERRY RD STE 700C, LAKE OSWEGO, OR 97035
(503) 888-2758
(503) 635-9127
Mailing address
15100 BOONES FERRY RD STE 700C, LAKE OSWEGO, OR 97035-3469
(503) 888-2758
(503) 635-9127
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
96-10-83
OR
1041C0700X
Clinical Social Worker
Primary
4164
OR
Other
Enumeration date
05/29/2009
Last updated
05/17/2018
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