Organization
INGRID S. LONGO, PC
Active
Other names
Ingrid S Longo MSW LICSW
Organization subpart
No
Provider details
NPI number
Authorized official
INGRID SCHOLZ LONGO LICSW (PRESIDENT)
(802) 365-7111
Entity
Organization
Contact information
Practice address
36 BACK ST, NEWFANE, VT 05345-9523
(802) 365-7111
(802) 365-7111
Mailing address
36 BACK ST, NEWFANE, VT 05345-9523
(802) 365-7111
(802) 365-7111
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
477
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN1736
—
VT
Enumeration date
01/18/2011
Last updated
07/07/2011
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