Provider Demographics
NPI:1053098483
Name:LANGFITT, KELLY (LMSW)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:LANGFITT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:IA
Mailing Address - Zip Code:50525-2019
Mailing Address - Country:US
Mailing Address - Phone:515-532-2836
Mailing Address - Fax:
Practice Address - Street 1:215 13TH AVE SW
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:IA
Practice Address - Zip Code:50525-2078
Practice Address - Country:US
Practice Address - Phone:515-532-2836
Practice Address - Fax:515-532-2523
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-28
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA102041104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA102041OtherSTATE OF IOWA