Active NPI
Gina Michelle Lang, PH.D.
- Clinical Psychologist
- Phoenix, AZ
National Provider Identifier
1407398100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3245
- Practice address
- 810 N 6TH Ave
Phoenix, AZ 85003-1318 - Phone
- (602) 462-1115
- NPI assigned
- Nov 11, 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3245 | AZ | Primary |
Addresses
Primary practice location
810 N 6TH Ave
Phoenix, AZ 85003-1318
Mailing address
810 N 6TH Ave
Phoenix, AZ 85003-1318
Phone (602) 462-1115
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3245 | AZ | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478822400000",
"number": "1407398100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 N 6TH AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850031318",
"telephone_number": "602-462-1115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 N 6TH AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850031318",
"telephone_number": "602-462-1115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANG",
"first_name": "GINA",
"middle_name": "MICHELLE",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-11",
"last_updated": "2016-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AZ",
"license": "3245",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.