Provider Demographics
NPI:1285196196
Name:LONG, EMMA TINSLEY-BOWLES (LCSW)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:TINSLEY-BOWLES
Last Name:LONG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 ARMOR CT SW
Mailing Address - Street 2:
Mailing Address - City:BOLLING AFB
Mailing Address - State:DC
Mailing Address - Zip Code:20032-7403
Mailing Address - Country:US
Mailing Address - Phone:804-366-3033
Mailing Address - Fax:
Practice Address - Street 1:13 ARMOR CT SW
Practice Address - Street 2:
Practice Address - City:BOLLING AFB
Practice Address - State:DC
Practice Address - Zip Code:20032-7403
Practice Address - Country:US
Practice Address - Phone:804-366-3033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-01
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040104101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical