Provider Demographics
NPI:1306020870
Name:LANGDON, CLAUDINE BERNICE (LCMHC)
Entity type:Individual
Prefix:
First Name:CLAUDINE
Middle Name:BERNICE
Last Name:LANGDON
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:CLAUDINE
Other - Middle Name:BERNICE
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1880 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-3657
Mailing Address - Country:US
Mailing Address - Phone:919-557-8222
Mailing Address - Fax:919-557-8223
Practice Address - Street 1:1880 N BROAD ST
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-3657
Practice Address - Country:US
Practice Address - Phone:919-557-8222
Practice Address - Fax:919-557-8223
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6827101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6006915Medicaid
NC6827OtherNCBLPC
NC6103792Medicaid