Provider Demographics
NPI:1871909176
Name:LANGDON, ALEXIS VICTORIA-KRESKE (MA, LPA, HSP-PA)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:VICTORIA-KRESKE
Last Name:LANGDON
Suffix:
Gender:F
Credentials:MA, LPA, HSP-PA
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:VICTORIA
Other - Last Name:KRESKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1772
Mailing Address - Street 2:
Mailing Address - City:SKYLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28776-1772
Mailing Address - Country:US
Mailing Address - Phone:786-256-3266
Mailing Address - Fax:
Practice Address - Street 1:111 MCDOWELL ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4409
Practice Address - Country:US
Practice Address - Phone:828-412-3144
Practice Address - Fax:828-782-3002
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-08
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4325103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist