Lisa Lang LLC

Primary specialty

Art TherapistTaxonomy code 221700000X

License

51-036 Issued in WI

Legal business name

LISA LANG LLC

Practice address

14135 North Cedarburg Road
Mequon, WI 53097

Phone

(414) 702-2324

NPI assigned

Apr 9, 2018

Organization subpart

No

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

Authorized official

Name

Ms. Lisa Lang, MS, ATRL-BCNPI 1902985922

Title

Licensed Psychotherapist

Phone

(414) 702-2119

Specialties & licenses 2

Addresses

Other identifiers 4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Lang, MS, ATRL-BC

  • Art Therapist
  • Mequon, WI
  • NPI 1902985922

  Mental Health

  NPD (past) Authorized official

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523232000000",
    "number": "1952808701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2027 NORTH 71ST STREET",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "53213",
            "telephone_number": "414-702-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14135 NORTH CEDARBURG ROAD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "53097",
            "telephone_number": "414-702-2324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA LANG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-09",
        "last_updated": "2018-04-09",
        "status": "A",
        "authorized_official_last_name": "LANG",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "LICENSED PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "414-702-2119",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, ATRL-BC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "51-036",
            "primary": false
        },
        {
            "code": "221700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Art Therapist",
            "state": "WI",
            "license": "51-036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOTHERAPY LICENSE #",
            "identifier": "51-036",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATCB BOARD CERTIFICATION #",
            "identifier": "01-226",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI #",
            "identifier": "1902985922",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40961100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Art Therapist in Mequon, WI
• Providers in Mequon, WI by specialty
• Art Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; 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.