Long, Ajasha Maxine

Long, Ajasha Maxine is an individual health care provider with primary practice located at 14540 Old Saint Augustine Rd Ste 2591 , Jacksonville FL 32258-7420. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Long, Ajasha Maxine can be contacted via phone (904) 376-3800.

Contact Information

Primary practice address
14540 Old Saint Augustine Rd Ste 2591 Jacksonville FL 32258-7420
Phone: (904) 376-3800
Fax: (904) 390-7405
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counseling 103TC1900X P.08309 Ohio
Behavioral Health & Social Service Providers / Psychologist 103T00000X PY12271 Florida

Profile Details

NPI number 1609495282
LBN Legal business name Long, Ajasha Maxine
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2020
Last updated Jun 3rd, 2024 - about 2 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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