Provider Demographics
NPI:1851282388
Name:LANGE, KELSEY M (LCSW)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:M
Last Name:LANGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11070 KATY FWY APT 1325
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-4767
Mailing Address - Country:US
Mailing Address - Phone:361-946-5955
Mailing Address - Fax:
Practice Address - Street 1:11070 KATY FWY APT 1325
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043-4767
Practice Address - Country:US
Practice Address - Phone:361-946-5955
Practice Address - Fax:361-946-5955
Is Sole Proprietor?:No
Enumeration Date:2025-07-12
Last Update Date:2025-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1055121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical