Active NPI
Nancy Erin Lange, LMSW
- Social Worker
- Davenport, IA
National Provider Identifier
1376904342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 05572
- Practice address
- 1202 W 3Rd St
Davenport, IA 52802-1344 - Phone
- (563) 324-9169
- NPI assigned
- Mar 17, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 05572 | IA | Primary |
Addresses
Primary practice location
1202 W 3Rd St
Davenport, IA 52802-1344
Mailing address
1202 W 3Rd St
Davenport, IA 52802-1344
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104307 | Medicaid | IA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 05572 | IA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bridgeview Community Mental Health Center | Social Worker | Past | Accepting new patients |
| Bethany for Children & Families | Social Worker | Past | Accepting new patients |
Organizations & group practices 2
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.
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Social Worker
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- NPI 1932178183
Social Worker
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458172800000",
"number": "1376904342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1202 W 3RD ST",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528021344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1202 W 3RD ST",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528021344",
"telephone_number": "563-324-9169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANGE",
"first_name": "NANCY",
"middle_name": "ERIN",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-17",
"last_updated": "2016-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IA",
"license": "05572",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1104307",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Davenport, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.