Provider Demographics
NPI:1194195032
Name:LANGLEY, STEVEN MATTHEW (LMT, LSW)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:MATTHEW
Last Name:LANGLEY
Suffix:
Gender:M
Credentials:LMT, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6415 BILLYMACK RD
Mailing Address - Street 2:
Mailing Address - City:ELIDA
Mailing Address - State:OH
Mailing Address - Zip Code:45807-9748
Mailing Address - Country:US
Mailing Address - Phone:419-302-4690
Mailing Address - Fax:
Practice Address - Street 1:797 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-1519
Practice Address - Country:US
Practice Address - Phone:419-229-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-05
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH022335225700000X
OHS.2004844104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist