Lange, Richard Theodore

Lange, Richard Theodore is an individual health care provider with primary practice located at 108 Somerdale Rd , Voorhees NJ 08043-1901. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Lange, Richard Theodore can be contacted via phone (856) 428-5688.

Contact Information

Primary practice address
108 Somerdale Rd Voorhees NJ 08043-1901
Phone: (856) 428-5688
Fax: (856) 795-4094
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 37PC00241100 New Jersey
Behavioral Health & Social Service Providers / Clinical 1041C0700X 44SC05250800 New Jersey

Profile Details

NPI number 1609991470
LBN Legal business name Lange, Richard Theodore
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2007
Last updated Jul 8th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609991470 NPPES
New Jersey Other 00166363300 INDEPENDENCE BC BC
New Jersey Other 2321500000 INDEPENDENCE BC BC
New Jersey Other 7119413 INDEPENDENCE BC BC

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