Provider Demographics
NPI:1376728816
Name:LANGE, ROBYN M (LADC)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:M
Last Name:LANGE
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 N GRANT ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68850-1946
Mailing Address - Country:US
Mailing Address - Phone:308-324-0222
Mailing Address - Fax:308-324-0225
Practice Address - Street 1:513 N GRANT ST
Practice Address - Street 2:SUITE 3A
Practice Address - City:LEXINGTON
Practice Address - State:NE
Practice Address - Zip Code:68850-1946
Practice Address - Country:US
Practice Address - Phone:308-324-0222
Practice Address - Fax:308-324-0225
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-03
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE897101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)