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General NPI Number Information
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NPI Number | 1396266722
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Entity Type | Individual
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Provider Name | STEVEN RUSSELL LONG LPC
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Gender | Male
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Dates
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Enumeration Date | 07/07/2017
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Last Update Date | 08/14/2017
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Provider Practice Location Address
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Address Line | 211 E PARKWOOD AVE STE 208
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-5387
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Country | US
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Telephone | 713-678-0403
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Fax |
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Provider Business Mailing Address
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Address Line | 2503 PILGRIMS POINT DR
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City | WEBSTER
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State | TX
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Zip | 77598-3227
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Country | US
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Telephone | 281-332-5314
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 68874
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License Number State | TX
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