Provider Demographics
NPI:1336877158
Name:LANG, CHELSEA (PHD)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:LANG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CHELSE
Other - Middle Name:
Other - Last Name:SONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:17809 E 105TH PL
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-9505
Mailing Address - Country:US
Mailing Address - Phone:252-814-4990
Mailing Address - Fax:
Practice Address - Street 1:2150 W 29TH AVE STE 330
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3889
Practice Address - Country:US
Practice Address - Phone:720-571-1130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist