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Individual

MADISON LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3050 HELMSDALE PL APT 11106, LEXINGTON, KY 40509-2532
(859) 388-9777
Mailing address
2250 THUNDERSTICK DR, LEXINGTON, KY 40505-9010
(859) 388-9777

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
KY
1041C0700X
Clinical Social Worker
259415
KY

Other

Enumeration date
02/10/2022
Last updated
01/15/2025
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