Provider Demographics
NPI:1033153150
Name:LANGELAND, VAN T (MS)
Entity Type:Individual
Prefix:
First Name:VAN
Middle Name:T
Last Name:LANGELAND
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 KIRKFIELD DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-6817
Mailing Address - Country:US
Mailing Address - Phone:919-851-8845
Mailing Address - Fax:
Practice Address - Street 1:106-D RIDGEVIEW DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-6647
Practice Address - Country:US
Practice Address - Phone:919-476-9995
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2393101YP2500X
NC418106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist