Active NPI
Tamara Lange, M.A.
- Marriage & Family Therapist
- Peabody, MA
National Provider Identifier
1992246581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1178
- Practice address
- 9 Centennial Dr
Suite 202
Peabody, MA 01960-7939 - Phone
- (978) 522-5055
- NPI assigned
- Mar 15, 2017
- Last updated
- Mar 15, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 3031612 | MA | |
| Marriage & Family Therapist | 106H00000X | 1178 | MA | Primary |
Addresses
Primary practice location
9 Centennial Dr
Suite 202
Peabody, MA 01960-7939
Mailing address
9 Centennial Dr
Suite 202
Peabody, MA 01960-7939
Phone (978) 522-5055
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04-2867023 | Medicaid | MA |
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3031612 | MA | MD | Social Worker |
| 1178 | MA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489536000000",
"number": "1992246581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 CENTENNIAL DR",
"address_2": "SUITE 202",
"city": "PEABODY",
"state": "MA",
"postal_code": "019607939",
"telephone_number": "978-522-5055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 CENTENNIAL DR",
"address_2": "SUITE 202",
"city": "PEABODY",
"state": "MA",
"postal_code": "019607939",
"telephone_number": "978-522-5055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANGE",
"first_name": "TAMARA",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-15",
"last_updated": "2017-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "3031612",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MA",
"license": "1178",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04-2867023",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peabody, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.