Provider Demographics
NPI:1740936574
Name:LONG, SARAH E (MSW, LSCW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:LONG
Suffix:
Gender:F
Credentials:MSW, LSCW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 S SAINT JOSEPH AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:MI
Mailing Address - Zip Code:49120-2848
Mailing Address - Country:US
Mailing Address - Phone:574-334-9594
Mailing Address - Fax:
Practice Address - Street 1:121 S SAINT JOSEPH AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:MI
Practice Address - Zip Code:49120-2848
Practice Address - Country:US
Practice Address - Phone:574-334-9594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical