Long, J. David
Long, J. David is an sole proprietor health care provider with primary practice located at 78 S Main St , Rutland VT 05701-4530. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Long, J. David can be contacted via phone (802) 775-8224.Contact Information
Primary practice address
78 S Main St
Rutland VT 05701-4530
Phone: (802) 775-8224
Fax: (802) 747-7699
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 0480000309 | Vermont |
Profile Details
| NPI number | 1255423927 |
|---|---|
| LBN Legal business name | Long, J. David |
| Credentials | PSYCHOLOGIST DOCTORA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 29th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1255423927 | NPPES |
| Vermont | Other | 9963 | BC/BS |
| Vermont | MEDICAID | 9534 | BC/BS |
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