Provider Demographics
NPI:1316117377
Name:LANGRICK, MARY ELIZABETH (LCSW)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:LANGRICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117A N GADSDEN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-6327
Mailing Address - Country:US
Mailing Address - Phone:850-270-7349
Mailing Address - Fax:866-450-3672
Practice Address - Street 1:2040 DELTA WAY
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-4226
Practice Address - Country:US
Practice Address - Phone:850-270-7349
Practice Address - Fax:866-450-3672
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-06
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW9148104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker