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Individual
JOHN M LONGO
Active
Individual
JOHN M LONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
1132
NH
1041C0700X
Clinical Social Worker
Primary
23841
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1132
LICSW
NH
01
—
23841
LICSW
MA
01
—
P03128
BLUE CROSS BLUE SHIELD
MA
Enumeration date
06/13/2006
Last updated
10/14/2019
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