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NPI Code Detail

MEDICARE: CAMERON WADE LONG LPC

MEDICARE: CAMERON WADE LONG LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor83713TX
2101YP2500XProfessional Counselor83713TX

General Provider Information

NPI Number : 1154042927
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAMERON WADE LONG LPC
Provider Business Mailing Address
First Line : 3910 W I 20 STE 100
Second Line :
City : ARLINGTON
State : TX
Zip : 76017-1430
Country : US
Telephone Number : 682-738-6533
Fax Number :
Provider Business Practice Location Address
First Line : 3910 W I 20 STE 100
Second Line :
City : ARLINGTON
State : TX
Zip : 76017-1430
Country : US
Telephone Number : 682-738-6533
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2022
Last Update Date : 03/25/2024

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Directions to “ CAMERON WADE LONG LPC” Practice Location

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