Michael Joseph Lange, M.S., L.P.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP3351 Issued in MN

Practice address

1703 Csah 15
St. Peter, MN 56082

Phone

(507) 933-5033

NPI assigned

Aug 20, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Inspire Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Montgomery, MN
  • NPI 1134691975
  NPD

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1588857072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32298 STATE HIGHWAY 13",
            "city": "MONTGOMERY",
            "state": "MN",
            "postal_code": "560694348",
            "telephone_number": "507-933-5033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 CSAH 15",
            "city": "ST. PETER",
            "state": "MN",
            "postal_code": "56082",
            "telephone_number": "507-933-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "M.S., L.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-20",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MN",
            "license": "LP3351",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGY LICENSE",
            "identifier": "LP3351",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Howard Krohn
• Ashley Krug, ATC
• Shannon Marie Kuball, LMFT
• Carol Jean Kuisle, LICSW
• Amy A Kvidera, MD
• Kevin James Langton, LADC
• Tara Lynn Lassen, APRN
• Zacharias D Laughlin, LPCC
• Laura J. Hulsebus P.a.
• Laura Tilton MD LLC

• Psychologist in St. Peter, MN
• Providers in St. Peter, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.