Individual
MS. GEORGETTA LYNN LANGLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC, ICADC
Contact information
Practice address
7400 FOUNTAINBLEAU RD, OCEAN SPRINGS, MS 39564-8473
(251) 377-3979
Mailing address
12506 FORTS LAKE RD, MOSS POINT, MS 39562-6510
(251) 377-3979
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
AD10-014L
MS
171M00000X
Case Manager/Care Coordinator
AD10-014L
MS
251B00000X
Case Management Agency
AD10-014L
MS
251S00000X
Community/Behavioral Health Agency
AD10-014L
MS
Other
Enumeration date
10/10/2017
Last updated
10/10/2017
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