Individual
MRS. JENNI REBECCA LONGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LISW, LCDCIII
Contact information
Practice address
163 N SANDUSKY ST STE 205, DELAWARE, OH 43015-1763
(614) 259-8737
Mailing address
163 N SANDUSKY ST STE 205, DELAWARE, OH 43015-1763
(614) 259-8737
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
001203
OH
1041C0700X
Clinical Social Worker
Primary
I.2002089
OH
1041C0700X
Clinical Social Worker
S27811
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0282079
—
OH
Enumeration date
10/14/2016
Last updated
09/28/2021
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