Provider Demographics
NPI:1154632867
Name:LANGFALD, DOUGLAS CLEO (MA, CLIN PSYCHOLO)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:CLEO
Last Name:LANGFALD
Suffix:
Gender:M
Credentials:MA, CLIN PSYCHOLO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 KIRK WOOD BLVD. SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52409
Mailing Address - Country:US
Mailing Address - Phone:319-364-0259
Mailing Address - Fax:866-290-5565
Practice Address - Street 1:980 SOUTH IOWA AVE
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50402
Practice Address - Country:US
Practice Address - Phone:641-423-3222
Practice Address - Fax:641-423-1740
Is Sole Proprietor?:No
Enumeration Date:2010-06-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IALMSW#03630101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health