=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447572763
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ZODELIA WILLIAMS-LANGLEY LMSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/01/2010
-----------------------------------------------------
Last Update Date | 03/12/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 420 BEACH 51ST ST
-----------------------------------------------------
City | FAR ROCKAWAY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11691-1048
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 171-847-4861
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 834 BARTH DR
-----------------------------------------------------
City | NORTH BALDWIN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11510-2004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 151-655-5121
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------