DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MS. DIANE MARIE LONG

MEDICARE: MS. DIANE MARIE LONG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1659669422
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DIANE MARIE LONG
Provider Business Mailing Address
First Line : 1215 SW G ST
Second Line :
City : GRANTS PASS
State : OR
Zip : 97526-2544
Country : US
Telephone Number : 541-476-2373
Fax Number : 541-476-1526
Provider Business Practice Location Address
First Line : 750 FRONT ST NE
Second Line :
City : SALEM
State : OR
Zip : 97301-1089
Country : US
Telephone Number : 503-363-2021
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2011
Last Update Date : 12/15/2022

Similar Medicare Providers

1790499390 — DIXIE LEE TORSAK CADC, QMHP, PCA
Practice Location Address:
750 FRONT ST NE
SALEM, OR
97301-1089
Practice Phone: 503-363-2021
Practice Fax:
1891831772 — MR. CARLOS OBED TEXIDOR MALDONADO PHD, LPC, MAC, ACS
Practice Location Address:
750 FRONT ST NE
SALEM, OR
97301-1089
Practice Phone: 503-363-2021
Practice Fax: 503-363-4820
1629114210 — MR. KEVIN J NORTHCOTT CADC II, QMHP-C
Practice Location Address:
750 FRONT ST NE
SALEM, OR
97301-1089
Practice Phone: 503-363-2021
Practice Fax:
1588849731 — MRS. DELMA MARIE HANSON-SMITH AA
Practice Location Address:
750 FRONT ST NE
SALEM, OR
97301-1089
Practice Phone: 503-363-2021
Practice Fax:
1083844401 — BRIDGEWAY RECOVERY SERVICES
Practice Location Address:
750 FRONT ST NE
SALEM, OR
97301-1089
Practice Phone: 503-363-2021
Practice Fax:
1619379633 — WANDA GETZ
Practice Location Address:
750 FRONT ST NE
SALEM, OR
97301-1089
Practice Phone: 503-363-2021
Practice Fax:

Directions to “ MS. DIANE MARIE LONG ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.