Individual
SARA MARIE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW,CSAC
Contact information
Practice address
301 E SAINT JOSEPH ST, GREEN BAY, WI 54301-2241
(920) 433-3630
Mailing address
PO BOX 22040, GREEN BAY, WI 54305-2040
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
17017-132
WI
1041C0700X
Clinical Social Worker
6801116062
MI
1041C0700X
Clinical Social Worker
Primary
9458-123
WI
Other
Enumeration date
01/07/2021
Last updated
04/03/2023
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