Provider Demographics
NPI:1881630168
Name:LONG, JANICE M (LICSW)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:M
Last Name:LONG
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:M
Other - Last Name:PRECOPIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3628
Mailing Address - Country:US
Mailing Address - Phone:603-668-4111
Mailing Address - Fax:603-628-7757
Practice Address - Street 1:2 WALL ST
Practice Address - Street 2:SUITE 300
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1518
Practice Address - Country:US
Practice Address - Phone:603-668-4111
Practice Address - Fax:603-628-7757
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH533104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker