Long, Jennifer

Long, Jennifer is an individual health care provider with primary practice located at 220 Washington Ave , Oshkosh WI 54901-5030. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Long, Jennifer can be contacted via phone (920) 236-4700.

Contact Information

Primary practice address
220 Washington Ave Oshkosh WI 54901-5030
Phone: (920) 236-4700
Fax: (920) 236-1157
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 129016121 Wisconsin
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 8465-123 Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X 8465-123 Wisconsin

Profile Details

NPI number 1720425309
LBN Legal business name Long, Jennifer
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2013
Last updated Nov 17th, 2016 - about 10 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 1720425309 NPPES
Wisconsin Other 000084287 MEDICARE
Wisconsin MEDICAID 42156000 MEDICARE
Wisconsin MEDICAID 42139300 MEDICARE

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