Provider Demographics
NPI:1922345859
Name:LANGE, CHRISTOPHER JULIAN (MA, LPC-INTERN)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JULIAN
Last Name:LANGE
Suffix:
Gender:M
Credentials:MA, LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19206 HUEBNER RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3146
Mailing Address - Country:US
Mailing Address - Phone:210-497-2880
Mailing Address - Fax:
Practice Address - Street 1:19206 HUEBNER RD
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3146
Practice Address - Country:US
Practice Address - Phone:210-497-2880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68351101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health