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General NPI Number Information
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NPI Number | 1003142142
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Entity Type | Individual
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Provider Name | ERIN MARIE LONG LPC
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Gender | Female
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Dates
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Enumeration Date | 10/25/2009
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 4161 BRIDGEWATER PKWY
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City | STOW
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State | OH
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Zip | 44224-6191
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Country | US
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Telephone | 330-865-4644
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Fax |
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Provider Business Mailing Address
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Address Line | 5509 TOWBRIDGE DR
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City | HUDSON
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State | OH
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Zip | 44236-2631
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Country | US
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Telephone | 330-608-4517
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C.0700023
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License Number State | OH
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