Provider Demographics
NPI:1174981682
Name:LANG, CHARLOTTE (LPC-I)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:LANG
Suffix:
Gender:F
Credentials:LPC-I
Other - Prefix:
Other - First Name:CHARLOTTE
Other - Middle Name:
Other - Last Name:LANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC-I
Mailing Address - Street 1:2150 GENERAL PERSHING ST
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-5125
Mailing Address - Country:US
Mailing Address - Phone:985-635-9225
Mailing Address - Fax:
Practice Address - Street 1:54002 HIGHWAY 1062
Practice Address - Street 2:
Practice Address - City:LORANGER
Practice Address - State:LA
Practice Address - Zip Code:70446-3538
Practice Address - Country:US
Practice Address - Phone:225-683-5292
Practice Address - Fax:225-683-1310
Is Sole Proprietor?:No
Enumeration Date:2016-01-29
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101Y00000X
LA6639101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor