Individual provider Active NPI

Thomas H Lange, LPC, MA

  • Professional Counselor
  • Fort Collins, CO
National Provider Identifier
1639575129
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC.0013482 Issued in CO
Practice address
114 Bristlecone Dr
Fort Collins, CO 80524-2031
Phone
(970) 494-4200
NPI assigned
Nov 10, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC.0013482 CO Primary

Addresses

Primary practice location

114 Bristlecone Dr
Fort Collins, CO 80524-2031

Mailing address

4856 Innovation Dr Ste B
Fort Collins, CO 80525-5540
Phone (970) 494-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240109002956 NY Practitioner - Mental Health Counselor 9032560511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Columbia Memorial HospitalGroup PAC ID 5092709410, 171 clinicians

Practice addresses (Care Compare)

71 Prospect Ave
Hudson, NY 12534-2927
Phone (518) 828-7601

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LPC.0013482COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Memorial Hospital CurrentSince Jan 1, 2024 Accepting new patients
Columbia Memorial Hospital CurrentSince Jan 1, 2024 Accepting new patients

Locations

71 Prospect Ave
Hudson, NY 12534
Phone (518) 262-3773

2827 US Highway 9
Valatie, NY 12184
Phone (518) 828-7601

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1415577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1639575129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4856 INNOVATION DR STE B",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255540",
            "telephone_number": "970-494-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 BRISTLECONE DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805242031",
            "telephone_number": "970-494-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "THOMAS",
        "middle_name": "H",
        "credential": "LPC, MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-10",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0013482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.