Provider Demographics
NPI:1326599481
Name:LANGEREIS, JOY VICTORIA (MSW)
Entity Type:Individual
Prefix:MS
First Name:JOY
Middle Name:VICTORIA
Last Name:LANGEREIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:799 HOMBACH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT IGNACE
Mailing Address - State:MI
Mailing Address - Zip Code:49781-1735
Mailing Address - Country:US
Mailing Address - Phone:906-298-0438
Mailing Address - Fax:
Practice Address - Street 1:1127 WEALTHY ST SE
Practice Address - Street 2:#3
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-1598
Practice Address - Country:US
Practice Address - Phone:616-780-6274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801100095104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker