Basic Information
| Provider Information | |||||||||
| NPI: | 1184071243 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LANGBEIN | ||||||||
| FirstName: | JESSLYN | ||||||||
| MiddleName: | PEARSON | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PLPC, CFLE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 126 SUNSET LN | ||||||||
| Address2: | |||||||||
| City: | DERIDDER | ||||||||
| State: | LA | ||||||||
| PostalCode: | 706346019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3373969432 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 115 WILSON ST | ||||||||
| Address2: | |||||||||
| City: | DERIDDER | ||||||||
| State: | LA | ||||||||
| PostalCode: | 706343823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3374634020 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2016 | ||||||||
| LastUpdateDate: | 05/18/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | PLC6408 | LA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.