Provider Demographics
NPI:1164599031
Name:LANG, JOSEPH PATRICK (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PATRICK
Last Name:LANG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:401 WEST THAMES STREET
Mailing Address - Street 2:SOUTHEASTERN MENTAL HEALTH AUTHORITY BLDG 301
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360
Mailing Address - Country:US
Mailing Address - Phone:860-859-4674
Mailing Address - Fax:860-859-4790
Practice Address - Street 1:401 WEST THAMES STREET
Practice Address - Street 2:SOUTHEASTERN MENTAL HEALTH AUTHORITY BLDG 301
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360
Practice Address - Country:US
Practice Address - Phone:860-859-4674
Practice Address - Fax:860-859-4790
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001875103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist