Healthcare Provider Details

I. General information

NPI: 1023765930
Provider Name (Legal Business Name): LAURA LANGEVIN PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2022
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 MENDON RD STE 4
WOONSOCKET RI
02895-6164
US

IV. Provider business mailing address

2345 MENDON RD STE 4
WOONSOCKET RI
02895-6164
US

V. Phone/Fax

Practice location:
  • Phone: 401-250-0123
  • Fax: 401-238-8769
Mailing address:
  • Phone: 401-250-5952
  • Fax: 401-238-8769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2022008828
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2303652
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN03406
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: