Healthcare Provider Details

I. General information

NPI: 1225801624
Provider Name (Legal Business Name): JULIE LONG LMTP, BCMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2023
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2707 DELMONICO DR
RICHMOND VA
23223-2532
US

IV. Provider business mailing address

3481 HOWARD RD
RICHMOND VA
23223-1429
US

V. Phone/Fax

Practice location:
  • Phone: 804-212-2698
  • Fax:
Mailing address:
  • Phone: 804-726-0197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225600000X
TaxonomyDance Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0019003869
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: