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Individual

SARAH J LONGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
8240 LAKESHORE CIR, APT 4214, INDIANAPOLIS, IN 46250-4852
(317) 902-0331
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
34006774A
IN
104100000X
Social Worker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
264430773
MEDICARE
IN
05
300043907
IN
Enumeration date
08/20/2010
Last updated
12/01/2022
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