Provider Demographics
NPI:1821656430
Name:LANGLEY, ELIZABETH DALE (PSYD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:DALE
Last Name:LANGLEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 DAYTON RD
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-1577
Mailing Address - Country:US
Mailing Address - Phone:732-690-7887
Mailing Address - Fax:
Practice Address - Street 1:280 N CENTRAL AVE STE 300
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1839
Practice Address - Country:US
Practice Address - Phone:914-288-5181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019691103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical