Provider Demographics
NPI:1891912945
Name:LANGSTON, ROBERT ALLEN (MA LSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ALLEN
Last Name:LANGSTON
Suffix:
Gender:M
Credentials:MA LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 BOYLSTON ST
Mailing Address - Street 2:#2
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-7930
Mailing Address - Country:US
Mailing Address - Phone:781-322-7737
Mailing Address - Fax:
Practice Address - Street 1:99 BOYLSTON ST
Practice Address - Street 2:2
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-7930
Practice Address - Country:US
Practice Address - Phone:781-322-7737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA302901101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health