Dustin James Lang, | |
907 W Caddo St, Cleveland, OK 74020-4201 | |
(918) 308-5511 | |
(918) 205-2701 |
Full Name | Dustin James Lang |
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Gender | Male |
Speciality | Social Worker - Clinical |
Location | 907 W Caddo St, Cleveland, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1497247142 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 7667 (Oklahoma) | Primary |
Entity Name | Grand Lake Mental Health Center, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1497762520 PECOS PAC ID: 4688711534 Enrollment ID: O20091026000174 |
Mailing Address | Practice Location Address |
---|---|
Dustin James Lang, 907 W Caddo St, Cleveland, OK 74020-4201 Ph: (918) 308-5511 | Dustin James Lang, 907 W Caddo St, Cleveland, OK 74020-4201 Ph: (918) 308-5511 |
Lisa Elledge, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1401 W Pawnee St, Cleveland, OK 74020 Phone: 918-358-2501 | |
Jordan Michael Westbrook, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 907 W Caddo St, Cleveland, OK 74020 Phone: 918-308-5511 | |
Brogan B A'neal, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 907 W Caddo St, Cleveland, OK 74020 Phone: 918-853-2095 |