Provider Demographics
NPI:1700321569
Name:LANGERHOLC, TIMOTHY W (LMHC)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:W
Last Name:LANGERHOLC
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 ROBERTA AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-6929
Mailing Address - Country:US
Mailing Address - Phone:561-376-9765
Mailing Address - Fax:
Practice Address - Street 1:2500 MAITLAND CENTER PKWY STE 250
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4174
Practice Address - Country:US
Practice Address - Phone:407-351-7080
Practice Address - Fax:407-351-6930
Is Sole Proprietor?:No
Enumeration Date:2017-01-03
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH16200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health