Doctor Name: | KELLY LONG |
NPI Number: | 1457564726 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW |
License Number: | |
Business Practice Address: | 15303 St. Rt 170 East Liverpool, OH - 439209216 |
Business Phone Number: | 3303851000 |
Business Fax Number: | 3303853588 |
Mailing Address: | 44360 Hammond School Rd, WELLSVILLE |
State: | OH |
Postal Code: | 439689776 |
Phone Number: | 3305184556 |
Fax Number: | 3303853588 |
NPI Enumeration Date: | 05/07/2007 |
NPI Last Update Date: | 10/30/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |