Healthcare Provider Details

I. General information

NPI: 1720950132
Provider Name (Legal Business Name): HEATHER LONG LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 BERRYVILLE AVE STE 1
WINCHESTER VA
22601-5907
US

IV. Provider business mailing address

1919 MILE HIGH STADIUM CIR APT 731
DENVER CO
80204-2765
US

V. Phone/Fax

Practice location:
  • Phone: 720-334-8029
  • Fax:
Mailing address:
  • Phone: 720-334-8029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701015811
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0022812
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: