Richard Long, MSW, LCSW, M.DIV.
Individual provider Active NPI Mental Health Counselor · Pendleton, IN
NPI 1003354598 · NPPES record last updated Feb 6, 2017
Key facts
- NPI
- 1003354598
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 34000540A (IN)
- Practice address
- 6745 Spring St
Pendleton, IN 46064-9026 - Phone
- (765) 778-0881
- NPI assigned
- Feb 6, 2017
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34000540A | IN | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 34000540A | IN | Yes |
| Professional Counselor | 101YP2500X | 34000540A | IN |
Addresses
Primary practice location
6745 Spring St
Pendleton, IN 46064-9026
Mailing address
6745 Spring St.
Pendleton, IN 46064
Phone (765) 778-0881
Other providers in Pendleton, IN
- Akilah Lamar
- Kenneth U Lau
- Jessica Jinell Lauterbach
- Lindsey Lawrence
- Julienne Elaine Leyva
- Luma Home Healthcare LLC
- Marsh Drugs LLC
- Vicki Carol Masterson
- Kenzie Mauro
- Brittnee McCance
All providers in Pendleton, IN · Mental Health Counselor in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.