Organization Name: | INGRID S. LONGO, PC |
NPI Number: | 1932404266 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | INGRID SCHOLZ LONGO (PRESIDENT) |
Mailing Address: | 36 Back St Newfane |
State: | VT US |
Postal Code: | 053459523 |
Phone Number: | 8023657111 |
Fax Number: | 8023657111 |
NPI Enumeration Date: | 01/18/2011 |
NPI Last Update Date: | 07/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 477 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |