| Beverly Long, Psy.d., L.p., Llc | |
|
546 Winona St E Saint Paul MN 55107-2425 | |
| (651) 253-8438 | |
| Not Available |
| Full Name | Beverly Long, Psy.d., L.p., Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 546 Winona St E, Saint Paul, Minnesota |
| Authorized Official Name and Position | Beverly Jean Long (PSYCHOLOGIST) |
| Authorized Official Contact | 6512538438 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beverly Long, Psy.d., L.p., Llc 546 Winona St E Saint Paul MN 55107-2425 Ph: (651) 253-8438 | Beverly Long, Psy.d., L.p., Llc 546 Winona St E Saint Paul MN 55107-2425 Ph: (651) 253-8438 |
| NPI Number | 1417147372 |
|---|---|
| Provider Enumeration Date | 07/26/2007 |
| Last Update Date | 07/26/2007 |
| Medicare PECOS PAC ID | 4082706197 |
|---|---|
| Medicare Enrollment ID | O20070822000072 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417147372 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LP1680 (Minnesota) | Primary |
| Provider Name | Beverly J Long |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306935804 PECOS PAC ID: 9739271842 Enrollment ID: I20070822000060 |
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