Dana Long, LMFT

Individual provider Active NPI Professional Counselor · Pitman, NJ

NPI 1376014688 · NPPES record last updated Sep 3, 2020

Key facts

NPI
1376014688
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
Practice address
140 S Broadway Ste 7
Pitman, NJ 08071-2235
Phone
(844) 365-7676
Fax
(844) 365-7676
NPI assigned
Dec 13, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Evolve Therapeutic Services Current
since Sep 6, 2020
Accepting new patients

Locations

140 S Broadway
Ste 7
Pitman, NJ 08071
Phone (609) 617-1405

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NJ Yes

Addresses

Primary practice location

140 S Broadway Ste 7
Pitman, NJ 08071-2235

Mailing address

PO Box 433
Elmer, NJ 08318-0433
Phone (844) 365-7676

Other providers in Pitman, NJ

All providers in Pitman, NJ · Professional Counselor in New Jersey

Sources for this page

Verify at the official NPI Registry.