Provider Demographics
NPI:1700287158
Name:LANG, JENNIFER E (LMFT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:E
Last Name:LANG
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:E
Other - Last Name:BROWN LANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:610 N LEBANON ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:IN
Mailing Address - Zip Code:46052-1716
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1650 W OAK ST STE 200
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-3836
Practice Address - Country:US
Practice Address - Phone:765-680-0071
Practice Address - Fax:765-680-0468
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001483A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist