Individual
CHRISTINE LONGMIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS, PH.D
Contact information
Practice address
6238 PENFIELD DR, FAYETTEVILLE, NC 28314-2061
(910) 728-3420
(910) 867-7622
Mailing address
6238 PENFIELD DR, FAYETTEVILLE, NC 28314-2061
(910) 728-3420
(910) 867-7622
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS 926
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6111752
—
NC
Enumeration date
01/30/2007
Last updated
09/29/2014
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