Provider Demographics
NPI:1528511870
Name:LANGDON BOUGIE, CATHERINE M (LPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:M
Last Name:LANGDON BOUGIE
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:M
Other - Last Name:LANGDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, NCC
Mailing Address - Street 1:W6152 RAWLEY POINT DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54942-8796
Mailing Address - Country:US
Mailing Address - Phone:920-335-0047
Mailing Address - Fax:
Practice Address - Street 1:436 E LONGVIEW DR STE A
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-2166
Practice Address - Country:US
Practice Address - Phone:920-335-0047
Practice Address - Fax:920-560-4472
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-03
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6071101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI6071-125OtherWISCONSIN STATE LICENSE NUMBER (LPC)