Healthcare Provider Details

I. General information

NPI: 1316019839
Provider Name (Legal Business Name): SCOTT A LANGENECKER PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 OLENTANGY RIVER RD
COLUMBUS OH
43214-3464
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-9600
  • Fax: 614-366-1215
Mailing address:
  • Phone: 614-293-9600
  • Fax: 614-366-1215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberP.08563
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberP.08563
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: