Individual provider Active NPI

Sidney Whitley Langston, PH.D., D.MIN., R.N.

  • Mental Health Counselor
  • Waxhaw, NC
National Provider Identifier
1104046416
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
076547 Issued in NC
Practice address
116 S. Providence St.
Waxhaw, NC 28173-1044
Phone
(704) 843-4818
Fax
(704) 843-5111
NPI assigned
Apr 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 076547 NC Primary

Addresses

Primary practice location

116 S. Providence St.
Waxhaw, NC 28173-1044

Mailing address

PO Box 327
116 S. Providence St.
Waxhaw, NC 28173-1044
Phone (704) 843-4818

Other identifiers 1

IdentifierTypeStateIssuer
50913OtherNCINSURANCE PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy, Registered Nurse

State licenses

LicenseStateTypeSpecialty
076547NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
El Rophe Center, Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104046416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 327",
            "address_2": "116 S. PROVIDENCE ST.",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281731044",
            "telephone_number": "704-843-4818",
            "fax_number": "704-843-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S. PROVIDENCE ST.",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281731044",
            "telephone_number": "704-843-4818",
            "fax_number": "704-843-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGSTON",
        "first_name": "SIDNEY",
        "middle_name": "WHITLEY",
        "name_prefix": "Dr.",
        "credential": "PH.D., D.MIN., R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "076547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE PROVIDER NUMBER",
            "identifier": "50913",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxhaw, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.