Healthcare Provider Details
I. General information
NPI: 1861891830
Provider Name (Legal Business Name): DARCY LANGELLA LSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/15/2014
Last Update Date: 08/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
50 PARK RD
WESTBROOK ME
04092-3176
US
IV. Provider business mailing address
899 RIVERSIDE ST
PORTLAND ME
04103-1070
US
V. Phone/Fax
- Phone: 207-871-1211
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: