Long, Jessica Lynn

Long, Jessica Lynn is an sole proprietor health care provider with primary practice located at 6816 W Rio Grande Ave Ste D , Kennewick WA 99336-7659. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Long, Jessica Lynn can be contacted via phone (509) 737-9009.

Contact Information

Primary practice address
6816 W Rio Grande Ave Ste D Kennewick WA 99336-7659
Phone: (509) 737-9009
Fax: (509) 737-9010
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Clinical 103TC0700X PY60253462 Washington

Profile Details

NPI number 1891946406
LBN Legal business name Long, Jessica Lynn
Credentials PSYD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 2nd, 2008
Last updated Mar 29th, 2022 - about 4 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 1891946406 NPPES
Rhode Island MEDICAID GH57134

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