Basic Information
| Provider Information | |||||||||
| NPI: | 1720451404 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SEALS-LANGSTON | ||||||||
| FirstName: | MARLA | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 445 WINN WAY FL 4 | ||||||||
| Address2: | |||||||||
| City: | DECATUR | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300301707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4045087796 | ||||||||
| FaxNumber: | 4042943710 | ||||||||
| Practice Location | |||||||||
| Address1: | 445 WINN WAY FL 4 | ||||||||
| Address2: | |||||||||
| City: | DECATUR | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4045087796 | ||||||||
| FaxNumber: | 4042943710 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2015 | ||||||||
| LastUpdateDate: | 06/03/2019 | ||||||||
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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 | 101YP2500X | LPC-15807 | AZ | N | Behavioral Health & Social Service Providers | Counselor | Professional | 101YM0800X | LPC010065 | GA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.