Individual
LISA G LANGSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
634 E PORTLAND ST, SPRINGFIELD, MO 65807-2073
(417) 849-5895
Mailing address
634 E PORTLAND ST, SPRINGFIELD, MO 65807-2073
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
000316
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14474626
CAQH
MO
Enumeration date
05/24/2019
Last updated
07/08/2022
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