Individual
KATHLEEN E. LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
56 CHURCH ST, WATERBURY, CT 06702-2103
(203) 755-1196
(203) 575-9675
Mailing address
21 SUSAN LN, MERIDEN, CT 06450-6848
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
000518
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
134082
VALUE OPTIONS
CT
01
—
297232
MHN
CT
01
—
77ABH0006CT08
ANTHEM BC/BS
CT
Enumeration date
09/02/2006
Last updated
07/08/2007
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