Individual
SERENA LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
125 S MAIN CROSS ST, LOUISA, KY 41230-1065
(606) 638-0938
Mailing address
125 S MAIN CROSS ST, LOUISA, KY 41230-1065
(606) 638-0938
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
290429
KY
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/27/2021
Last updated
03/20/2024
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