Basic Information
| Provider Information | |||||||||
| NPI: | 1861604456 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LENGEFELD | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | |||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 201 S ROSE ST | ||||||||
| Address2: | |||||||||
| City: | SHERIDAN | ||||||||
| State: | AR | ||||||||
| PostalCode: | 721502451 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8709172171 | ||||||||
| FaxNumber: | 8709172161 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 S ROSE ST | ||||||||
| Address2: | |||||||||
| City: | SHERIDAN | ||||||||
| State: | AR | ||||||||
| PostalCode: | 721502451 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8709172171 | ||||||||
| FaxNumber: | 8709172161 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2007 | ||||||||
| LastUpdateDate: | 03/13/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | P0910065 | AR | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.