Provider Demographics
NPI:1962632406
Name:LANGNER, DAUGHON (PSYD, LCP, BCN)
Entity Type:Individual
Prefix:DR
First Name:DAUGHON
Middle Name:
Last Name:LANGNER
Suffix:
Gender:F
Credentials:PSYD, LCP, BCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 S PLYMOUTH CT
Mailing Address - Street 2:059
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-1845
Mailing Address - Country:US
Mailing Address - Phone:210-663-4530
Mailing Address - Fax:775-521-7598
Practice Address - Street 1:30 N MICHIGAN AVE
Practice Address - Street 2:1610
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3402
Practice Address - Country:US
Practice Address - Phone:210-663-4530
Practice Address - Fax:775-521-7598
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178006088101YP2500X
IL071008033103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01623882OtherBC/BS