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NPI Code Detail

MEDICARE: MS. EDITH ELEANOR LANGLEY MA,LMFT

MEDICARE: MS. EDITH ELEANOR LANGLEY MA,LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistLMFT 0589NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1135F1OTHERNCBCBSNC PROVIDER ID

General Provider Information

NPI Number : 1194927137
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. EDITH ELEANOR LANGLEY MA,LMFT
Provider Business Mailing Address
First Line : 4726 PARK RD
Second Line : SUITE B
City : CHARLOTTE
State : NC
Zip : 28209-3278
Country : US
Telephone Number : 704-527-0760
Fax Number : 704-527-0887
Provider Business Practice Location Address
First Line : 4726 PARK RD
Second Line : SUITE B
City : CHARLOTTE
State : NC
Zip : 28209-3278
Country : US
Telephone Number : 704-527-0760
Fax Number : 704-527-0887
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2007
Last Update Date : 07/08/2007

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