Provider Demographics
NPI:1164052932
Name:LANG, KIRA DIANE (LMSW)
Entity Type:Individual
Prefix:
First Name:KIRA
Middle Name:DIANE
Last Name:LANG
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1981 LAWRENCE HWY
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48813-7800
Mailing Address - Country:US
Mailing Address - Phone:517-667-0210
Mailing Address - Fax:
Practice Address - Street 1:6211 W WILLOW HWY
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-1231
Practice Address - Country:US
Practice Address - Phone:517-667-0210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-21
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI11640529321041C0700X
MI68011083721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical