Provider Demographics
NPI:1881920692
Name:LANGEHENNIG CROSS, AMBER LEE (MED, LPC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LEE
Last Name:LANGEHENNIG CROSS
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 53991
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79453-3991
Mailing Address - Country:US
Mailing Address - Phone:806-368-0291
Mailing Address - Fax:806-368-0291
Practice Address - Street 1:6110 16TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79416-6139
Practice Address - Country:US
Practice Address - Phone:806-368-0291
Practice Address - Fax:806-368-0291
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-29
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61994101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional