Provider Demographics
NPI:1235295163
Name:LONG, WILLIAM FRANCIS (PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:FRANCIS
Last Name:LONG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 BERKSHIRE DRIVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-1733
Mailing Address - Country:US
Mailing Address - Phone:518-877-8941
Mailing Address - Fax:518-373-6686
Practice Address - Street 1:56 CLIFTON COUNTRY RD
Practice Address - Street 2:SUITE 206
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3838
Practice Address - Country:US
Practice Address - Phone:518-371-7202
Practice Address - Fax:518-373-6686
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4769103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical