Provider Demographics
NPI:1265511109
Name:LANGKILDE, AREFEH PARTOVI (LPC EDS)
Entity Type:Individual
Prefix:MRS
First Name:AREFEH
Middle Name:PARTOVI
Last Name:LANGKILDE
Suffix:
Gender:F
Credentials:LPC EDS
Other - Prefix:MRS
Other - First Name:AREFEH
Other - Middle Name:P
Other - Last Name:LANGKILDE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:EDS
Mailing Address - Street 1:PO BOX 73
Mailing Address - Street 2:
Mailing Address - City:WINSTON
Mailing Address - State:GA
Mailing Address - Zip Code:30187
Mailing Address - Country:US
Mailing Address - Phone:770-489-2415
Mailing Address - Fax:770-489-2568
Practice Address - Street 1:8309 C OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134
Practice Address - Country:US
Practice Address - Phone:770-489-2415
Practice Address - Fax:770-489-2568
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1822101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional