Provider Demographics
NPI:1306918438
Name:LANGVARDT, SHARON ANN (MS)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:ANN
Last Name:LANGVARDT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 FAIRWAY DRIVE
Mailing Address - Street 2:
Mailing Address - City:BEATRICE
Mailing Address - State:NE
Mailing Address - Zip Code:68310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:123 N 9TH ST
Practice Address - Street 2:BLUE VALLEY MENTAL HEALTH CENTER
Practice Address - City:BEATRICE
Practice Address - State:NE
Practice Address - Zip Code:68310
Practice Address - Country:US
Practice Address - Phone:402-228-3386
Practice Address - Fax:402-228-2004
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE836101YM0800X
NE6106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470528515-13Medicaid
NE470528515-15Medicaid
NE470528515-10Medicaid
NE470528515-81Medicaid
NE470528515-05Medicaid
NE470528515-06Medicaid
NE470528515-02Medicaid
NE470528515-07Medicaid
NE470528515-09Medicaid
NE470528515-14Medicaid
NE470528515-08Medicaid
NE84943OtherBCBS
NE470528515-00Medicaid
NE470528515-03Medicaid
NE1097OtherMIDLANDS CHOICE
NE470528515-01Medicaid
NE470528515-04Medicaid
NE470528515-17Medicaid