Provider Demographics
NPI:1689972770
Name:DR. LONG, LLC
Entity Type:Organization
Organization Name:DR. LONG, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:LONG
Authorized Official - Suffix:JR
Authorized Official - Credentials:THD, LCSW
Authorized Official - Phone:973-584-1370
Mailing Address - Street 1:6 NAUGHRIGHT RD
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-5610
Mailing Address - Country:US
Mailing Address - Phone:973-584-1370
Mailing Address - Fax:908-979-1129
Practice Address - Street 1:6 NAUGHRIGHT RD
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-5610
Practice Address - Country:US
Practice Address - Phone:973-584-1370
Practice Address - Fax:908-979-1129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SCD4552500251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health