Provider Demographics
NPI:1215295720
Name:LONGHI, LEANNA
Entity type:Individual
Prefix:
First Name:LEANNA
Middle Name:
Last Name:LONGHI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 FAIR HILL LN
Mailing Address - Street 2:
Mailing Address - City:SUFFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06078-1202
Mailing Address - Country:US
Mailing Address - Phone:203-923-7557
Mailing Address - Fax:
Practice Address - Street 1:14 HAZARD AVE STE 23-1037
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-3713
Practice Address - Country:US
Practice Address - Phone:203-923-7557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9146101YM0800X
CT8105101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health