Long, Jody G
Long, Jody G is an sole proprietor health care provider with primary practice located at 1910 Nonconnah Blvd Suite 120, Memphis TN 38132-2113. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Long, Jody G can be contacted via phone (901) 448-2300.Contact Information
Primary practice address
1910 Nonconnah Blvd Suite 120
Memphis TN 38132-2113
Phone: (901) 448-2300
Fax: (901) 448-6657
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 3638 | Tennessee |
Profile Details
| NPI number | 1548228307 |
|---|---|
| LBN Legal business name | Long, Jody G |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 2nd, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548228307 | NPPES |
| Tennessee | MEDICAID | 3920189 |
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