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General NPI Number Information
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NPI Number | 1548128036
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Entity Type | Individual
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Provider Name | ALEXANDER ANDRE' LONG PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 01/13/2026
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 165 N MAIN ST
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City | BOWLING GREEN
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State | OH
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Zip | 43402-2458
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Country | US
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Telephone | 419-582-9053
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Fax |
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Provider Business Mailing Address
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Address Line | 321 E CAPITAL ST UNIT 910
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City | COLUMBUS
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State | OH
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Zip | 43215-4270
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Country | US
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Telephone |
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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 |
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License Number State |
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