Provider Demographics
NPI:1255407748
Name:LANGMEAD, MICHELLE (LCSW)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:LANGMEAD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 OP MED READINESS SQ
Mailing Address - Street 2:MENTAL HEALTH OSC-SGXW
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09094
Mailing Address - Country:US
Mailing Address - Phone:496-371-4614
Mailing Address - Fax:
Practice Address - Street 1:86 OP MED READINESS SQ
Practice Address - Street 2:MENTAL HEALTH OSC-SGXW
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09094
Practice Address - Country:US
Practice Address - Phone:496-371-4614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX213421041C0700X
CA924131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00000051MEOtherBCBS PROVIDER NUMBER
TX1730277Medicaid
TX21342OtherSTATE LICENSE
TX00000051MEOtherBCBS PROVIDER NUMBER