Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JEREMY DE WAYNE LONG, LMHC, LPC
ActiveMR. JEREMY DE WAYNE LONG, LMHC, LPC is a Professional Counselor healthcare provider located in WEST MELBOURNE, Florida. NPI 1831458561 is currently active in the NPPES registry. Verify at CMS.
Professional Counselor · WEST MELBOURNE, FL
Registration Details
- NPI Number
- 1831458561
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 15, 2012 (14.259164620615 yrs)
- Last Updated
- Aug 24, 2020
- Licenses
-
MH 11075 (FL)5617-125 (WI)
Practice Information
- Address
-
870 HOLLYWOOD BLVDWEST MELBOURNE, FL, 329047418Browse FL providers · Browse ZIP 32904
- Phone
- 8004381772
- Fax
- 2623455562
- Primary Specialty
-
Professional Counselor
101YP2500X
- Additional Specialty
- Professional Counselor
Other Professional Counselor Providers in WEST MELBOURNE, FL
| Name | Credential | NPI |
|---|---|---|
| TAMMY JEAN BASSILE | RN, MA | 1588954432 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.