Provider Demographics
NPI:1184208894
Name:LU, HUAN-TANG (PHD, LMHC, PMHNP)
Entity type:Individual
Prefix:
First Name:HUAN-TANG
Middle Name:
Last Name:LU
Suffix:
Gender:
Credentials:PHD, LMHC, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 STORRS RD STE B1011
Mailing Address - Street 2:
Mailing Address - City:WILLIMANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06226-4011
Mailing Address - Country:US
Mailing Address - Phone:856-818-3985
Mailing Address - Fax:
Practice Address - Street 1:600 WORCESTER RD STE 501
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-5316
Practice Address - Country:US
Practice Address - Phone:856-818-3966
Practice Address - Fax:856-249-9630
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-09
Last Update Date:2025-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC10001034101YM0800X
NJ37PC00678300101YP2500X
CT12.014538363LP0808X
NJ26NJ15287500363LP0808X
MDR270651363LP0808X
OR10041805363LP0808X
MARN2391993363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional