Provider Demographics
NPI:1346372430
Name:LANGLEY, NICOLE DAWN (BA)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:DAWN
Last Name:LANGLEY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MISS
Other - First Name:NICOLE
Other - Middle Name:DAWN
Other - Last Name:GALLEGOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:3426 S LOCUST ST
Mailing Address - Street 2:APT. D
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-7611
Mailing Address - Country:US
Mailing Address - Phone:970-381-1374
Mailing Address - Fax:
Practice Address - Street 1:8989 HURON ST
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80260-6858
Practice Address - Country:US
Practice Address - Phone:303-853-3646
Practice Address - Fax:303-287-6893
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health