Provider Demographics
NPI:1821452913
Name:LANG COUNSELING AND CONSULTING GROUP, LLC
Entity Type:Organization
Organization Name:LANG COUNSELING AND CONSULTING GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOUASHA
Authorized Official - Middle Name:KEYWONA
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:850-665-0027
Mailing Address - Street 1:PO BOX 1061
Mailing Address - Street 2:
Mailing Address - City:MIDWAY
Mailing Address - State:FL
Mailing Address - Zip Code:32343-1061
Mailing Address - Country:US
Mailing Address - Phone:850-665-0027
Mailing Address - Fax:850-792-6084
Practice Address - Street 1:1290 CEDAR CENTER DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-4876
Practice Address - Country:US
Practice Address - Phone:850-665-0027
Practice Address - Fax:850-792-6084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW127601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty