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NPI Code Detail

MEDICARE: SHERIDENE LEIGH LONG LCSW

MEDICARE: SHERIDENE LEIGH LONG LCSW
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 Counselor
2171M00000XCase Manager/Care Coordinator
31041C0700XClinical Social Worker17372LA

General Provider Information

NPI Number : 1891241766
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHERIDENE LEIGH LONG LCSW
Provider Business Mailing Address
First Line : 420 MAGNOLIA ST
Second Line :
City : HOUMA
State : LA
Zip : 70360-6304
Country : US
Telephone Number : 985-879-3966
Fax Number :
Provider Business Practice Location Address
First Line : 235 CIVIC CENTER BLVD
Second Line :
City : HOUMA
State : LA
Zip : 70360-5937
Country : US
Telephone Number : 985-333-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2016
Last Update Date : 03/13/2026

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Directions to “ SHERIDENE LEIGH LONG LCSW” Practice Location

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