Provider Demographics
NPI:1902929573
Name:LANGEVIN, KATIE ALEXIS (MA, LMHC)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:ALEXIS
Last Name:LANGEVIN
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 FLORENCE ST
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-2622
Mailing Address - Country:US
Mailing Address - Phone:617-877-6754
Mailing Address - Fax:
Practice Address - Street 1:1309 BEACON ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5271
Practice Address - Country:US
Practice Address - Phone:617-877-6754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6576101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health