Individual
IVY LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
184 ELDRIDGE ST, NEW YORK, NY 10002-2992
(212) 674-9120
Mailing address
122 BAY 29TH ST APT 4, BROOKLYN, NY 11214-5078
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
130035
NY
172V00000X
Community Health Worker
Primary
130035
NY
Other
Enumeration date
12/12/2025
Last updated
12/12/2025
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