Individual
MR. BRAD LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
215 E MAIN ST, PROVIDENCE, KY 42450-1261
(270) 667-7017
(270) 667-9065
Mailing address
PO BOX 37, PROVIDENCE, KY 42450-0037
(270) 667-7017
(270) 667-9065
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
KY
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
08/04/2011
Last updated
12/08/2017
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