Individual
STEPHEN R LONGLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
143 CHURCH ST, DORSET, VT 05251-2001
(802) 445-5703
Mailing address
PO BOX 56, DORSET, VT 05251-0056
(802) 445-5703
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089.0135756
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6715970
—
VT
Enumeration date
09/27/2021
Last updated
07/16/2024
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