Shirley Jo Lange, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4293 Issued in OH

Practice address

7100 N High St Ste 304
Worthington, OH 43085-2316

Phone

(614) 725-1957

Fax

(614) 846-1059

NPI assigned

Feb 13, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1154463297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 N HIGH ST STE 304",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430852316",
            "telephone_number": "614-725-1957",
            "fax_number": "614-846-1059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 N HIGH ST STE 304",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430852316",
            "telephone_number": "614-725-1957",
            "fax_number": "614-846-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "SHIRLEY",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "4293",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "4293",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "4293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0840648",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Lane
• Donald David Lanese, D.O.
• Angelena Lang
• Taylor Lang
• Travis M Langan, DPM
• Yania Langford
• Jan Evans Lantz, LISW
• Nora Elia Lara Sanchez
• Ethan D Larned
• Grayson M Lassiter

• Clinical Psychologist in Worthington, OH
• Providers in Worthington, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.