Provider Demographics
NPI:1205295383
Name:LANGONI, TYLER JAY (LMSW)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:JAY
Last Name:LANGONI
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5656 S CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-3894
Mailing Address - Country:US
Mailing Address - Phone:269-873-2243
Mailing Address - Fax:269-223-6202
Practice Address - Street 1:5656 S CEDAR ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-3894
Practice Address - Country:US
Practice Address - Phone:269-873-2243
Practice Address - Fax:269-223-6202
Is Sole Proprietor?:No
Enumeration Date:2016-02-17
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010989821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical