Provider Demographics
NPI:1700296860
Name:LANG, CHRISTENA (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTENA
Middle Name:
Last Name:LANG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 ACADIA LN
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-4213
Mailing Address - Country:US
Mailing Address - Phone:318-464-7008
Mailing Address - Fax:
Practice Address - Street 1:500 TURTLE COVE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-5300
Practice Address - Country:US
Practice Address - Phone:682-999-8201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11897101YA0400X
FLSW118611041C0700X
TX559021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)