Provider Demographics
NPI:1861722241
Name:LONG, VALERIE JANE (LSW, CAC, CCDP)
Entity type:Individual
Prefix:MISS
First Name:VALERIE
Middle Name:JANE
Last Name:LONG
Suffix:
Gender:F
Credentials:LSW, CAC, CCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 GIBNER RD. # 508
Mailing Address - Street 2:DUNHAM ARMY HEALTH CLINIC
Mailing Address - City:CARLISLE BARRACKS
Mailing Address - State:PA
Mailing Address - Zip Code:17013
Mailing Address - Country:US
Mailing Address - Phone:717-245-4082
Mailing Address - Fax:717-245-4653
Practice Address - Street 1:450 GIBNER RD. # 508
Practice Address - Street 2:DUNHAM ARMY HEALTH CLINIC
Practice Address - City:CARLISLE BARRACKS
Practice Address - State:PA
Practice Address - Zip Code:17013
Practice Address - Country:US
Practice Address - Phone:717-245-4082
Practice Address - Fax:717-245-4653
Is Sole Proprietor?:No
Enumeration Date:2010-01-06
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0173291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical