Provider Demographics
NPI:1700494440
Name:LONG, KATIE GUERRY (LCSWA)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:GUERRY
Last Name:LONG
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:523 ROCKINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-3615
Mailing Address - Country:US
Mailing Address - Phone:910-562-9882
Mailing Address - Fax:910-562-9955
Practice Address - Street 1:232 E FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-3627
Practice Address - Country:US
Practice Address - Phone:910-817-7417
Practice Address - Fax:910-817-7218
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0169331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical