Provider Demographics
NPI:1154795979
Name:LANGAN, THOMAS
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:LANGAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 MAIN ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-5042
Mailing Address - Country:US
Mailing Address - Phone:781-246-1964
Mailing Address - Fax:781-213-3470
Practice Address - Street 1:338 MAIN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-5042
Practice Address - Country:US
Practice Address - Phone:781-246-1964
Practice Address - Fax:781-213-3470
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health