Individual provider · Type 1 NPI
Jeremy De Wayne Long, LMHC, LPC
Professional Counselor · West Melbourne, FL
NPI number
1831458561
Active
Practice location
870 Hollywood Blvd
West Melbourne, FL 32904-7418
Fax (262) 345-5562
Mailing address
630 Tejon Ave SW
Palm Bay, FL 32908-7437
Other practice locations
- 690 Friday Rd, Cocoa, FL 32926-3317 · (321) 636-9941
- W175N11120 Stonewood Dr, Germantown, WI 53022-4799 · (800) 438-1772
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor | 101YM0800X | MH 11075 (FL) |
| Professional Counselor Primary | 101YP2500X | 5617-125 (WI) |
Professional Counselor: Definition to come...
Another provider at this address
Other professional counselor providers in West Melbourne
About NPI 1831458561
Jeremy De Wayne Long, LMHC, LPC's National Provider Identifier is 1831458561, issued on May 15, 2012. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in West Melbourne, FL. The record was last updated on Aug 24, 2020.