Provider Demographics
NPI:1063602134
Name:LANGREDER, JUDITH ANN (LPC)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:ANN
Last Name:LANGREDER
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:PO BOX 8885
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-0131
Mailing Address - Country:US
Mailing Address - Phone:623-332-6150
Mailing Address - Fax:623-243-6150
Practice Address - Street 1:12211 W BELL RD
Practice Address - Street 2:109
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-9521
Practice Address - Country:US
Practice Address - Phone:623-332-6150
Practice Address - Fax:623-243-6207
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10833101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional