Provider Demographics
NPI:1578224606
Name:ERIN LANGWELL LLC
Entity Type:Organization
Organization Name:ERIN LANGWELL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-224-5114
Mailing Address - Street 1:46036 MICHIGAN AVE STE 166
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-2304
Mailing Address - Country:US
Mailing Address - Phone:734-224-5114
Mailing Address - Fax:
Practice Address - Street 1:39674 BART ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187
Practice Address - Country:US
Practice Address - Phone:734-224-5114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty