Provider Demographics
NPI:1346001864
Name:LANGE, MONIQUE (PLADC)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:
Last Name:LANGE
Suffix:
Gender:F
Credentials:PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5875
Mailing Address - Country:US
Mailing Address - Phone:402-371-0220
Mailing Address - Fax:
Practice Address - Street 1:910 W PARK AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-5044
Practice Address - Country:US
Practice Address - Phone:402-370-2667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor