Connie D Langford, PH.D.
Individual provider Active NPI Counselor · Rockmart, GA
NPI 1205181740 · NPPES record last updated Jul 20, 2012
Key facts
- NPI
- 1205181740
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 03072007 (GA)
- Practice address
- 302 Martin Luther King Jr St
Rockmart, GA 30153-1810 - Phone
- (770) 402-9827
- NPI assigned
- Jul 20, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03072007 | GA | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 03072007 | GA | Yes |
Addresses
Primary practice location
302 Martin Luther King Jr St
Rockmart, GA 30153-1810
Mailing address
302 Martin Luther King Jr St
Rockmart, GA 30153-1810
Phone (770) 402-9827
Other providers in Rockmart, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.