Provider Demographics
NPI:1194836031
Name:BENDER LONG, LUANNE FAYE (LPC, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:LUANNE
Middle Name:FAYE
Last Name:BENDER LONG
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MACTANLY PL STE B
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-2383
Mailing Address - Country:US
Mailing Address - Phone:540-885-3481
Mailing Address - Fax:540-885-3508
Practice Address - Street 1:100 MACTANLY PL STE B
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-2383
Practice Address - Country:US
Practice Address - Phone:540-885-3481
Practice Address - Fax:540-885-3508
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002566101YP2500X
VA0717000738106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
560382OtherVALUE OPTIONS
O88503MOtherSOUTHERN HEALTH
VA193663OtherANTHEM
2108713OtherCIGNA