| Mr Jeremy De Wayne Long, LMHC, LPC | |
|
870 Hollywood Blvd, West Melbourne, FL 32904-7418 | |
| (800) 438-1772 | |
| (262) 345-5562 |
| Full Name | Mr Jeremy De Wayne Long |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 870 Hollywood Blvd, West Melbourne, Florida |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831458561 | NPI | - | NPPES |
| 100057489 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH 11075 (Florida) | Secondary |
| 101YP2500X | Counselor - Professional | 5617-125 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Jeremy De Wayne Long, LMHC, LPC 630 Tejon Ave Sw, Palm Bay, FL 32908-7437 Ph: (321) 482-9492 | Mr Jeremy De Wayne Long, LMHC, LPC 870 Hollywood Blvd, West Melbourne, FL 32904-7418 Ph: (800) 438-1772 |
Maria Sanders, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2000 Commerce Dr, West Melbourne, FL 32904 Phone: 321-676-6650 | |
Meagan Jimenez, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2000 Commerce Dr, West Melbourne, FL 32904 Phone: 321-676-6650 | |
Laurie Ann Carter, PHD, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2350 Dairy Rd, West Melbourne, FL 32904 Phone: 321-632-5792 | |
Alexus Claude-williams, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2000 Commerce Dr, West Melbourne, FL 32904 Phone: 321-676-6650 | |
Jennifer David, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2000 Commerce Dr, West Melbourne, FL 32904 Phone: 321-722-5200 | |
Vanessa Matthews, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2000 Commerce Dr, West Melbourne, FL 32904 Phone: 321-676-6650 | |
Lydiana Venega, MS, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1938 Dairy Rd, West Melbourne, FL 32904 Phone: 321-574-0888 |