Healthcare Provider Details

I. General information

NPI: 1568218741
Provider Name (Legal Business Name): COURTNEY ELIZABETH LONG LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COURTNEY WALSH

II. Dates (important events)

Enumeration Date: 04/27/2024
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 N WASHINGTON AVE STE 104
SCRANTON PA
18503-1511
US

IV. Provider business mailing address

908 N LONGWOOD DR
SOUTH ABINGTON TOWNSHIP PA
18411-2801
US

V. Phone/Fax

Practice location:
  • Phone: 570-961-3361
  • Fax: 570-961-3364
Mailing address:
  • Phone: 703-541-8306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC016881
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: