Doctor Name: | MR. BRIAN LEE LONG |
NPI Number: | 1932475779 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 006744 |
Business Practice Address: | 410 Peachtree Pkwy 4245 Cumming, GA - 300417066 |
Business Phone Number: | 4046448967 |
Business Fax Number: | |
Mailing Address: | 562 Lakeland Plz # 326, CUMMING |
State: | GA |
Postal Code: | 300402783 |
Phone Number: | 4046448967 |
Fax Number: | 6782611622 |
NPI Enumeration Date: | 03/27/2012 |
NPI Last Update Date: | 02/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 006744 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
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 |