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General NPI Number Information
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NPI Number | 1992956338
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Entity Type | Individual
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Provider Name | LEANNE J LONG LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 10/03/2008
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Last Update Date | 07/23/2012
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Provider Practice Location Address
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Address Line | 4800 MARK CENTER DR 14E08
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City | ALEXANDRIA
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State | VA
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Zip | 22350-2300
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Country | US
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Telephone | 571-372-5328
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Fax |
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Provider Business Mailing Address
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Address Line | 4800 MARK CENTER DR 14E08
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City | ALEXANDRIA
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State | VA
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Zip | 22350-2300
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Country | US
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Telephone | 571-372-5328
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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 | 0701004468
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License Number State | VA
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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 | 867
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 20026
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License Number State | TX
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