Provider Demographics
NPI:1710164769
Name:LONG, RACHEL (LCSW)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:
Last Name:LONG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEADOWLANDS PLAZA
Mailing Address - Street 2:SUITE #200
Mailing Address - City:EAST RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07073
Mailing Address - Country:US
Mailing Address - Phone:201-286-1122
Mailing Address - Fax:
Practice Address - Street 1:1 MEADOWLANDS PLAZA
Practice Address - Street 2:SUITE #200
Practice Address - City:EAST RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07073
Practice Address - Country:US
Practice Address - Phone:201-286-1122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2024-09-04
Deactivation Date:2019-09-25
Deactivation Code:
Reactivation Date:2024-09-04
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052672001041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical