Individual
MARTHA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHC, LADC
Contact information
Practice address
87 WASHINGTON ST, CONWAY, NH 03818-6044
(800) 439-3347
Mailing address
87 WASHINGTON ST, CONWAY, NH 03818-6044
(800) 439-3347
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
148
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
148
LCMHC NUMBER
NH
Enumeration date
03/07/2007
Last updated
07/08/2007
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