Healthcare Provider Details

I. General information

NPI: 1184237620
Provider Name (Legal Business Name): BRITNI KAY LANGEVIN LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITNI KAY JOUBERT LPCC

II. Dates (important events)

Enumeration Date: 08/25/2020
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 37TH AVE S
MOORHEAD MN
56560-5524
US

IV. Provider business mailing address

PO BOX 9859
FARGO ND
58106-9859
US

V. Phone/Fax

Practice location:
  • Phone: 701-451-4811
  • Fax: 651-925-0057
Mailing address:
  • Phone: 701-451-4900
  • Fax: 651-925-0057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2435
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: