Individual provider Active NPI

William Lange, LCDCIII

  • Addiction (Substance Use Disorder) Counselor
  • Dayton, OH
National Provider Identifier
1245843846
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LCDCIII162565 Issued in OH
Practice address
4977 Northcutt PL
Dayton, OH 45414-3839
Phone
(800) 829-5461
NPI assigned
Aug 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCDCIII162565 OH Primary

Addresses

Primary practice location

4977 Northcutt PL
Dayton, OH 45414-3839

Mailing address

5849 Penelope Dr
Fairfield Township, OH 45011-2211
Phone (513) 823-6979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCDCIII162565OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1245843846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5849 PENELOPE DR",
            "city": "FAIRFIELD TOWNSHIP",
            "state": "OH",
            "postal_code": "450112211",
            "telephone_number": "513-823-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4977 NORTHCUTT PL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454143839",
            "telephone_number": "800-829-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "WILLIAM",
        "credential": "LCDCIII",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-25",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDCIII162565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.