Provider Demographics
NPI:1538567359
Name:LANGSTON, LINDA (LPC, CEAP, SAE)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:LANGSTON
Suffix:
Gender:F
Credentials:LPC, CEAP, SAE
Other - Prefix:
Other - First Name:LINDY
Other - Middle Name:
Other - Last Name:LANGSTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC, CEAP, SAE
Mailing Address - Street 1:110 CONVERSE ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-1310
Mailing Address - Country:US
Mailing Address - Phone:864-608-0508
Mailing Address - Fax:
Practice Address - Street 1:110 CONVERSE ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-1310
Practice Address - Country:US
Practice Address - Phone:864-608-0508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4890101YP2500X
NC5118101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional