Provider Demographics
NPI:1992033542
Name:LANGEN, ROBERT ALAN (LCSW-R)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ALAN
Last Name:LANGEN
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CANTERBURY RD STE 303
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-3448
Mailing Address - Country:US
Mailing Address - Phone:585-340-6961
Mailing Address - Fax:206-339-5359
Practice Address - Street 1:25 CANTERBURY RD STE 303
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-3448
Practice Address - Country:US
Practice Address - Phone:585-340-6961
Practice Address - Fax:206-339-5359
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-19
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0803211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty