Provider Demographics
NPI:1003065186
Name:LANGEVIN, MARCI LYNN (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:MARCI
Middle Name:LYNN
Last Name:LANGEVIN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MRS
Other - First Name:MARCI
Other - Middle Name:LYNN
Other - Last Name:LANGEVIN-GAUDETTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:386 STANLEY STREET
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-6009
Mailing Address - Country:US
Mailing Address - Phone:508-679-5222
Mailing Address - Fax:508-676-5671
Practice Address - Street 1:386 STANLEY ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-6009
Practice Address - Country:US
Practice Address - Phone:508-679-5222
Practice Address - Fax:508-676-5671
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical