Tiffany Mae Lange, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810005526 Issued in VA

Practice address

501 Prince George Street
Suite 307
Williamburg, VA 23185

Phone

(757) 903-2406

NPI assigned

Jul 19, 2010

Reactivated

Dec 9, 2021

Last updated

Jan 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Tiffany Mae Lange - Altman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1376856377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 25TH ST",
            "address_2": "APT 503",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23451",
            "telephone_number": "419-260-3919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 PRINCE GEORGE STREET",
            "address_2": "SUITE 307",
            "city": "WILLIAMBURG",
            "state": "VA",
            "postal_code": "23185",
            "telephone_number": "757-903-2406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "TIFFANY",
        "middle_name": "MAE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-19",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "deactivation_date": "2021-08-13",
        "reactivation_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810005526",
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "VA",
            "license": "0810005S26",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "LANGE - ALTMAN",
            "middle_name": "MAE",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Learning and Growing Beyond Inc

• Clinical Psychologist in Williamburg, VA
• Providers in Williamburg, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.