Provider Demographics
NPI:1225691603
Name:LANGE, CYNTHIA BROOKE (LPC, LCADC)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:BROOKE
Last Name:LANGE
Suffix:
Gender:F
Credentials:LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3322 ROUTE 22 STE 801
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-4406
Mailing Address - Country:US
Mailing Address - Phone:609-577-5726
Mailing Address - Fax:
Practice Address - Street 1:3322 ROUTE 22 WEST
Practice Address - Street 2:SUITE 801
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876
Practice Address - Country:US
Practice Address - Phone:609-577-5726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-21
Last Update Date:2019-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00067200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional