Individual
MRS. LANIECE CHEVETTE LANGLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
800 LEGION ST, CONWAY, SC 29526-4825
(843) 254-8960
Mailing address
800 LEGION ST, CONWAY, SC 29526-4825
(843) 254-8960
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
10382
SC
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
10382
SC
101YP2500X
Professional Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16405013
CAQH
SC
01
—
PC3090
NON-EMERGENCY TRANSPORTATION
SC
05
—
PC3090
—
SC
Enumeration date
05/19/2015
Last updated
01/25/2025
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