Nicholas Mark Lange, LPC/LMFT

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401018602 Issued in MI

Practice address

6255 28TH St. SE
Suite 3, Offices C&D
Grand Rapids, MI 49546

Phone

(231) 286-2355

NPI assigned

Jan 11, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Real Talk Therapy PLLC

  • Professional Counselor
  • Grand Rapids, MI
  • NPI 1770367237
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1083122147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "599 OAK MEADOW DR",
            "city": "MIDDLEVILLE",
            "state": "MI",
            "postal_code": "493338478",
            "telephone_number": "231-286-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6255 28TH ST. SE",
            "address_2": "SUITE 3, OFFICES C&D",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49546",
            "telephone_number": "231-286-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "NICHOLAS",
        "middle_name": "MARK",
        "credential": "LPC/LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-11",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101007011",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401018602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1715928",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kurt Lang, DC
• Rachael Lang
• Robert D. Lang, MD
• Alissa Langan
• Charles Langdon, MD
• Rebecca Lange
• Dawn Langejans
• Carol A. Langeland, OTRL
• Robert Francis Langen, MD
• Emily S Langenau, LMSW

• Professional Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.