Individual
MRS. VICKIE LONGWILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDC, ADC III, ICADC
Contact information
Practice address
2040 NORTH LOOP WEST, SUITE 335, HOUSTON, TX 77018-8127
(713) 628-2980
(713) 681-3800
Mailing address
2040 NORTH LOOP WEST, SUITE 335, HOUSTON, TX 77018-8127
(713) 628-2980
(713) 681-3800
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2070
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115651
THE INTERNATIONAL CERTIFICATION & RECEPROCITY CONSORTIUM
TX
01
—
2070
DEPARTMENT OF STATE HEALTH SERVICES
TX
01
—
9551-0991
TEXAS CERTIFICATION BOARD OF ADDICTION PROFESSIONALS
TX
Enumeration date
08/21/2007
Last updated
01/27/2011
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