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NPI Code Detail

MEDICARE: SHAWNE LANGSTON

MEDICARE: SHAWNE LANGSTON
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
1101YA0400XAddiction (Substance Use Disorder) Counselor146LA
2101YP2500XProfessional Counselor3791LA

General Provider Information

NPI Number : 1871951079
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAWNE LANGSTON
Provider Business Mailing Address
First Line : 4255 E BROOKSTOWN DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70805-4603
Country : US
Telephone Number : 225-936-8773
Fax Number : 225-927-0771
Provider Business Practice Location Address
First Line : 4255 E BROOKSTOWN DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70805-4603
Country : US
Telephone Number : 225-936-8773
Fax Number : 225-927-0770
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2016
Last Update Date : 02/02/2016

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Directions to “ SHAWNE LANGSTON ” Practice Location

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