Provider Demographics
NPI:1851494801
Name:LONGMIRE, DAVID JOSEPH (LP, LMHC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JOSEPH
Last Name:LONGMIRE
Suffix:
Gender:M
Credentials:LP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 E 5TH ST APT 2 # 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-8596
Mailing Address - Country:US
Mailing Address - Phone:212-475-3562
Mailing Address - Fax:
Practice Address - Street 1:201 E. 34TH ST.
Practice Address - Street 2:GESTALT ASSOCIATES FOR PSYCHOTHERAPY,
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:917-362-3562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3031101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health