Provider Demographics
NPI:1902266349
Name:LANGLEY, MELISSA JOY (LPC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JOY
Last Name:LANGLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 WEALTHY ST SE
Mailing Address - Street 2:SUITE 236
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-2762
Mailing Address - Country:US
Mailing Address - Phone:616-328-3756
Mailing Address - Fax:616-940-9166
Practice Address - Street 1:1514 WEALTHY ST SE
Practice Address - Street 2:SUITE 236
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-2762
Practice Address - Country:US
Practice Address - Phone:616-328-3756
Practice Address - Fax:616-940-9166
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-27
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011385101Y00000X, 101YM0800X, 106H00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist