Provider Demographics
NPI:1053810317
Name:LANGSTON, JESSICA ROBBY (LPCA)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ROBBY
Last Name:LANGSTON
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MILLER ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28716-3827
Mailing Address - Country:US
Mailing Address - Phone:828-242-2949
Mailing Address - Fax:
Practice Address - Street 1:12 MILLER ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:NC
Practice Address - Zip Code:28716-3827
Practice Address - Country:US
Practice Address - Phone:828-242-2949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12822101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health