Provider Demographics
NPI:1598257511
Name:LANGWELL, ERIN KATHLEEN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:KATHLEEN
Last Name:LANGWELL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:JACKETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLMSW
Mailing Address - Street 1:8623 N WAYNE RD #123
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185
Mailing Address - Country:US
Mailing Address - Phone:810-227-6218
Mailing Address - Fax:
Practice Address - Street 1:8623 N WAYNE RD #123
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185
Practice Address - Country:US
Practice Address - Phone:810-227-6218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010958941041C0700X
MI6801109007101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical