Provider Demographics
NPI:1912194507
Name:LONGO, JEFF ANTHONY (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JEFF
Middle Name:ANTHONY
Last Name:LONGO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:666 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-1913
Mailing Address - Country:US
Mailing Address - Phone:412-561-5405
Mailing Address - Fax:412-561-4581
Practice Address - Street 1:666 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-1913
Practice Address - Country:US
Practice Address - Phone:412-561-5405
Practice Address - Fax:412-561-4581
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0148231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical