Provider Demographics
NPI:1255419560
Name:LANGFORD, ELLA H (LCSW)
Entity type:Individual
Prefix:MS
First Name:ELLA
Middle Name:H
Last Name:LANGFORD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 E. MAIN STREET, SUITE 205
Mailing Address - Street 2:P.O. BOX 26984
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23261-6984
Mailing Address - Country:US
Mailing Address - Phone:804-241-3707
Mailing Address - Fax:804-819-4262
Practice Address - Street 1:3030 MONTROSE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23222-2510
Practice Address - Country:US
Practice Address - Phone:804-241-3707
Practice Address - Fax:804-819-4262
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA8902763Medicaid