Provider Demographics
NPI:1437452588
Name:LANG, MARCIA A (LICSW)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:A
Last Name:LANG
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:MARCIA
Other - Middle Name:A
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:2121 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-3803
Mailing Address - Country:US
Mailing Address - Phone:304-485-1721
Mailing Address - Fax:304-485-9203
Practice Address - Street 1:2121 7TH ST
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3803
Practice Address - Country:US
Practice Address - Phone:304-485-1721
Practice Address - Fax:304-485-9203
Is Sole Proprietor?:No
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP009435361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical