MR. Jeremy De Wayne Long, LMHC, LPC

NPI #1831458561 in West Melbourne, Florida

Provider Information

NPI Number: 1831458561
Entity Type: Individual
Name: MR. Jeremy De Wayne Long, LMHC, LPC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Credential: LMHC, LPC
Enumeration Date: May 15, 2012
Last Updated: Aug 24, 2020

Practice Location

Address: 870 HOLLYWOOD BLVD
City: West Melbourne
State: Florida
ZIP Code: 32904-7418
Phone: (800) 438-1772

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Counselor - Professional — Professional	101YP2500X	Primary

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