Healthcare Provider Details

I. General information

NPI: 1326569872
Provider Name (Legal Business Name): SARAH ELIZABETH LONG LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 PIGEON ROOST RD
RUSH KY
41168-8132
US

IV. Provider business mailing address

2901 PIGEON ROOST RD
RUSH KY
41168-8132
US

V. Phone/Fax

Practice location:
  • Phone: 606-928-6648
  • Fax: 606-928-1056
Mailing address:
  • Phone: 606-928-6648
  • Fax: 606-928-1056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number290461
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: