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General NPI Number Information
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NPI Number | 1720362841
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Entity Type | Organization
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Legal Business Name | M LONGLEY COUNSELING AND CONSULTING SERVICES, PLLC
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Dates
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Enumeration Date | 10/07/2011
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Last Update Date | 10/07/2011
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Provider Practice Location Address
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Address Line | 333 N 2ND ST SUITE 303
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City | NILES
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State | MI
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Zip | 49120-2258
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Country | US
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Telephone | 269-687-5050
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Fax | 269-687-5050
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Provider Business Mailing Address
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Address Line | 333 N 2ND ST SUITE 303
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City | NILES
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State | MI
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Zip | 49120-2258
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Country | US
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Telephone | 269-687-5050
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Fax | 269-687-5050
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MS. MELISSA ANN LONGLEY
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Credential | LMSW, LCSW
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Telephone | 269-687-5050
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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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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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