Provider Demographics
NPI:1326215591
Name:LANGDON, LEILANI (LCSW)
Entity Type:Individual
Prefix:
First Name:LEILANI
Middle Name:
Last Name:LANGDON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LEILANI
Other - Middle Name:
Other - Last Name:MERCADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1850 COLFAX AVE
Mailing Address - Street 2:
Mailing Address - City:BENTON HARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49022-6753
Mailing Address - Country:US
Mailing Address - Phone:269-926-6199
Mailing Address - Fax:269-926-6780
Practice Address - Street 1:29 SOUTH WEBSTER STREET SUITE 260
Practice Address - Street 2:
Practice Address - City:MAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540
Practice Address - Country:US
Practice Address - Phone:815-407-7236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor