Long, Timothy Richard

Long, Timothy Richard is an individual health care provider with primary practice located at 160 Draper Ave C/O Child Inc., Warwick RI 02889-5047. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Long, Timothy Richard can be contacted via phone (401) 732-5200.

Contact Information

Primary practice address
160 Draper Ave C/O Child Inc. Warwick RI 02889-5047
Phone: (401) 732-5200
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X ISW01394 Rhode Island
Behavioral Health & Social Service Providers / Clinical 1041C0700X 1024584 Massachusetts

Profile Details

NPI number 1114979986
LBN Legal business name Long, Timothy Richard
Credentials LICSW
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Nov 9th, 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 1114979986 NPPES
Rhode Island Other 29583 BLUE CROSS COMMERCIAL
Rhode Island MEDICAID TL43466 BLUE CROSS COMMERCIAL
Rhode Island Other 412638 BLUE CROSS COMMERCIAL

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