Individual
GARY W LONG JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW-C
Contact information
Practice address
922 NATIONAL HWY, LAVALE, MD 21502-7325
(240) 362-7294
(240) 362-7357
Mailing address
922 NATIONAL HWY, LAVALE, MD 21502-7325
(240) 362-7294
(240) 362-7357
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20551
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20551
BOARD OF SOCIAL WORK-LICENSE VERIFICATION INFORMATION
MD
Enumeration date
08/29/2017
Last updated
07/21/2022
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