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General NPI Number Information
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NPI Number | 1043660699
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Entity Type | Organization
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Legal Business Name | R. LONG COUNSELING & CONSULTING, LLC
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Dates
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Enumeration Date | 06/14/2016
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Last Update Date | 01/13/2020
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Provider Practice Location Address
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Address Line | 80 BROAD STREET C/O REGUS- 5TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10004
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Country | US
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Telephone | 201-286-1122
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Fax |
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Provider Business Mailing Address
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Address Line | 80 BROAD STREET C/O REGUS- 5TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10004
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Country | US
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Telephone | 201-286-1122
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MS. RACHEL LONG
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Credential |
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Telephone | 201-286-1122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 083911
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License Number State | NY
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