Provider Demographics
NPI:1003802836
Name:LANGFORD, SCOTT ANTHONY (LCSW)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:ANTHONY
Last Name:LANGFORD
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1670
Mailing Address - Street 2:1109 N 100 W
Mailing Address - City:BEAVER
Mailing Address - State:UT
Mailing Address - Zip Code:84713-1670
Mailing Address - Country:US
Mailing Address - Phone:435-438-7100
Mailing Address - Fax:435-438-7166
Practice Address - Street 1:1109 N 100 W
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:UT
Practice Address - Zip Code:84713-1670
Practice Address - Country:US
Practice Address - Phone:435-438-7100
Practice Address - Fax:435-438-7166
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT313168-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTP23152Medicare UPIN