Lange, Nicholas Mark

Lange, Nicholas Mark is an individual health care provider with primary practice located at 6255 28Th St. Se Suite 3, Offices C&D, Grand Rapids MI 49546. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Lange, Nicholas Mark can be contacted via phone (231) 286-2355.

Contact Information

Primary practice address
6255 28Th St. Se Suite 3, Offices C&D Grand Rapids MI 49546
Phone: (231) 286-2355
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 4101007011 Michigan
Behavioral Health & Social Service Providers / Professional 101YP2500X 6401018602 Michigan

Profile Details

NPI number 1083122147
LBN Legal business name Lange, Nicholas Mark
Credentials LPC/LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2018
Last updated Aug 24th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1083122147 NPPES
Michigan MEDICAID 1715928

Popular Providers