Provider Demographics
NPI:1104001254
Name:LANGE, CHELI (LPC)
Entity Type:Individual
Prefix:
First Name:CHELI
Middle Name:
Last Name:LANGE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 FARMINGTON AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2135
Mailing Address - Country:US
Mailing Address - Phone:860-561-4841
Mailing Address - Fax:860-561-4891
Practice Address - Street 1:1001 FARMINGTON AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2135
Practice Address - Country:US
Practice Address - Phone:860-561-4841
Practice Address - Fax:860-561-4891
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health