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General NPI Number Information
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NPI Number | 1437226701
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Entity Type | Individual
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Provider Name | RICHARD T. LONGO ED.D.
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Gender | Male
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 04/16/2018
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Provider Practice Location Address
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Address Line | 167 DWIGHT ROAD SUITE #104
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City | LONGMEADOW
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State | MA
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Zip | 01106
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Country | US
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Telephone | 413-519-1960
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Fax | 413-224-1592
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Provider Business Mailing Address
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Address Line | 39 BROADLEAF CIRCLE
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City | EAST LONGMEADOW
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State | MA
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Zip | 01028
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Country | US
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Telephone | 413-519-1960
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Fax | 413-224-1592
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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 | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number | 6395
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 6395
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6395
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 6395
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License Number State | MA
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Taxonomy #5
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | 6395
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License Number State | MA
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Taxonomy #6
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number | 6395
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License Number State | MA
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Taxonomy #7
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 6395
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License Number State | MA
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Taxonomy #8
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6395
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License Number State | MA
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