Provider Demographics
NPI:1134639966
Name:LANGLOIS, JEAN-ROBERT (LPCC-S)
Entity Type:Individual
Prefix:
First Name:JEAN-ROBERT
Middle Name:
Last Name:LANGLOIS
Suffix:
Gender:M
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 E 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43211-2603
Mailing Address - Country:US
Mailing Address - Phone:614-224-4506
Mailing Address - Fax:614-291-0118
Practice Address - Street 1:547 E 11TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211-2603
Practice Address - Country:US
Practice Address - Phone:614-224-4506
Practice Address - Fax:614-291-0118
Is Sole Proprietor?:No
Enumeration Date:2017-10-06
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1901270101YP2500X
OHE.1901270-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0345797Medicaid