Provider Demographics
NPI:1225288616
Name:DORIS LANGSTON, LCSW, P.C.
Entity Type:Organization
Organization Name:DORIS LANGSTON, LCSW, P.C.
Other - Org Name:DORIS LANGSTON, LCSW
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:HEWES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-353-7760
Mailing Address - Street 1:1002 W GORE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73501-3723
Mailing Address - Country:US
Mailing Address - Phone:580-353-7760
Mailing Address - Fax:580-351-0084
Practice Address - Street 1:1002 W GORE BLVD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73501-3723
Practice Address - Country:US
Practice Address - Phone:580-353-7760
Practice Address - Fax:580-351-0084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK=========OtherTAX ID