Provider Demographics
NPI:1801433818
Name:LANG, JULIE KAY (MSW, LSW)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:KAY
Last Name:LANG
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 W IRVING PARK RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-2825
Mailing Address - Country:US
Mailing Address - Phone:773-653-2261
Mailing Address - Fax:773-736-6970
Practice Address - Street 1:4300 W IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-2825
Practice Address - Country:US
Practice Address - Phone:773-653-2261
Practice Address - Fax:773-736-6970
Is Sole Proprietor?:No
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150104088101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional