Provider Demographics
NPI:1700076130
Name:LANGER, LAURIE RUTH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:RUTH
Last Name:LANGER
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 1:292 RIVIERA CIR
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-1507
Mailing Address - Country:US
Mailing Address - Phone:925-946-1622
Mailing Address - Fax:415-563-1600
Practice Address - Street 1:1849 BONANZA ST
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4317
Practice Address - Country:US
Practice Address - Phone:925-946-1622
Practice Address - Fax:415-563-1600
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical