Long, Mary Margaret
Long, Mary Margaret is an individual health care provider with primary practice located at Avenue D'Oslo Bldg 401 Unit 21420, Apo AE 09705. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Long, Mary Margaret can be contacted via phone (314) 566-5320.Contact Information
Primary practice address
Avenue D'Oslo Bldg 401 Unit 21420
Apo AE 09705
Phone: (314) 566-5320
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 501904 | |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | LCPC-3666 | Idaho |
Profile Details
| NPI number | 1629102124 |
|---|---|
| LBN Legal business name | Long, Mary Margaret |
| Credentials | LCPC, MAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 15th, 2007 |
| Last updated | Jul 20th, 2021 - about 3 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 | 1629102124 | NPPES |
| Idaho | MEDICAID | 002269500 | |
| Idaho | Other | 000010146797 | |
| Idaho | Other | Q7358 |
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