Provider Demographics
NPI:1528030459
Name:LONGTON, JULIE A (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:A
Last Name:LONGTON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CARVER AVE
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-3316
Mailing Address - Country:US
Mailing Address - Phone:860-886-0289
Mailing Address - Fax:
Practice Address - Street 1:20 CARVER AVE
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-3316
Practice Address - Country:US
Practice Address - Phone:860-886-8233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-03
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000769106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT158299OtherVALUE OPTIONS
CT410000CT76901OtherANTHEM BLUE CROSS BLUE SH
CT004205721OtherCONNECTICUT BHP
CTP2823195OtherOXFORD HEALTH PLANS
CT487312000OtherMAGELLAN
CT7132131OtherAETNA BEHAVIORAL HEALTH
CT185761OtherMANAGED HEALTH NETWORK