Individual
ELIZABETH VICTORIA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
100 EXECUTIVE PARK STE 103, LOUISVILLE, KY 40207-4201
(502) 313-6880
(502) 473-1334
Mailing address
10100 ELIDA RD, DELPHOS, OH 45833-9056
(419) 695-8010
(419) 695-0004
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
254350
KY
1041C0700X
Clinical Social Worker
Primary
257161
KY
Other
Enumeration date
08/23/2019
Last updated
03/27/2023
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