Provider Demographics
NPI:1073702023
Name:LANGSTON, MARY ASHLEY (CSW)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ASHLEY
Last Name:LANGSTON
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:ASHLEY
Other - Last Name:MCFATTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8931 HURON ST
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80260-6806
Mailing Address - Country:US
Mailing Address - Phone:303-853-3500
Mailing Address - Fax:
Practice Address - Street 1:8931 HURON ST
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80260-6806
Practice Address - Country:US
Practice Address - Phone:303-853-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0058441041C0700X
CO099234251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6003409Medicaid
NC139UJOtherNVML BCBSNC GRP 015HF
NC6003409Medicaid