Provider Demographics
NPI:1447470414
Name:MENDEZ-LANGBERG, SOPHIE MICHELLE (LMFT)
Entity type:Individual
Prefix:
First Name:SOPHIE
Middle Name:MICHELLE
Last Name:MENDEZ-LANGBERG
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16911 CRESTVIEW LN
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1580
Mailing Address - Country:US
Mailing Address - Phone:954-802-0156
Mailing Address - Fax:
Practice Address - Street 1:150 S UNIVERSITY DR
Practice Address - Street 2:SUITE A
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3359
Practice Address - Country:US
Practice Address - Phone:954-806-2004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
FLMT2315106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist