Provider Demographics
NPI:1336838614
Name:JENNIFER LANG COUNSELING PLCC
Entity Type:Organization
Organization Name:JENNIFER LANG COUNSELING PLCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:503-775-5833
Mailing Address - Street 1:5208 NEW MEXICO ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-6621
Mailing Address - Country:US
Mailing Address - Phone:503-775-5833
Mailing Address - Fax:
Practice Address - Street 1:5208 NEW MEXICO ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-6621
Practice Address - Country:US
Practice Address - Phone:360-397-7322
Practice Address - Fax:360-397-7322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty