Individual
LEE K LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2410 HWY 65 N, DEETA COUNSELING ASSOCIATES INC, MCGEHEE, AR 71654
(870) 222-3107
Mailing address
PO BOX 34, SAINT CHARLES, AR 72140-0034
(870) 282-3113
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1672C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50088
BCBS
AR
Enumeration date
07/28/2006
Last updated
07/08/2007
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