Individual
MATTHEW LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC, LPCC
Contact information
Practice address
90 DALE ST S, SAINT PAUL, MN 55102-2812
(651) 278-7980
Mailing address
90 DALE ST S, SAINT PAUL, MN 55102-2812
(651) 278-7980
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
305742
MN
101YM0800X
Mental Health Counselor
3618
MN
101YM0800X
Mental Health Counselor
Primary
CC03618
MN
Other
Enumeration date
11/28/2022
Last updated
03/13/2025
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