Lange, Shirley Jo
Lange, Shirley Jo is an sole proprietor health care provider with primary practice located at 7100 N High St Ste 304 , Worthington OH 43085-2316. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Lange, Shirley Jo can be contacted via phone (614) 725-1957.Contact Information
Primary practice address
7100 N High St Ste 304
Worthington OH 43085-2316
Phone: (614) 725-1957
Fax: (614) 846-1059
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 4293 | Ohio |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 103TA0400X | 4293 | Ohio |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 4293 | Ohio |
Profile Details
| NPI number | 1154463297 |
|---|---|
| LBN Legal business name | Lange, Shirley Jo |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 13th, 2007 |
| Last updated | Oct 21st, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154463297 | NPPES |
| Ohio | MEDICAID | 0840648 |
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