Provider Demographics
NPI:1013725050
Name:LANG, SAMUEL D (MS, LMHC)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:D
Last Name:LANG
Suffix:
Gender:M
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 SOLE MIA SQUARE LN
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-1242
Mailing Address - Country:US
Mailing Address - Phone:786-302-8567
Mailing Address - Fax:
Practice Address - Street 1:2200 SOLE MIA SQUARE LN
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-1242
Practice Address - Country:US
Practice Address - Phone:786-302-8567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH24690101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health