Provider Demographics
NPI:1558794719
Name:LONGMIRE'S COUNSELING, CONSULTING, & TRAINING L.L.C.
Entity Type:Organization
Organization Name:LONGMIRE'S COUNSELING, CONSULTING, & TRAINING L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LONGMIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-728-3420
Mailing Address - Street 1:PO BOX 35788
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-0788
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5114 YADKIN RD
Practice Address - Street 2:SUITE 128
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-6012
Practice Address - Country:US
Practice Address - Phone:910-867-7622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-026-937261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)