Long, J. David

Long, J. David is an sole proprietor health care provider with primary practice located at 78 S Main St , Rutland VT 05701-4530. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Long, J. David can be contacted via phone (802) 775-8224.

Contact Information

Primary practice address
78 S Main St Rutland VT 05701-4530
Fax: (802) 747-7699
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 0480000309 Vermont

Profile Details

NPI number 1255423927
LBN Legal business name Long, J. David
Credentials PSYCHOLOGIST DOCTORA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 29th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255423927 NPPES
Vermont Other 9963 BC/BS
Vermont MEDICAID 9534 BC/BS

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