Provider Demographics
NPI:1700081882
Name:LANGE, VALERIE JEAN (LPC)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:JEAN
Last Name:LANGE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 POCATELLO DR
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-6449
Mailing Address - Country:US
Mailing Address - Phone:701-258-8273
Mailing Address - Fax:
Practice Address - Street 1:1501 N 12TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-2713
Practice Address - Country:US
Practice Address - Phone:701-255-3325
Practice Address - Fax:701-250-6469
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND175-9-1-91101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health