Provider Demographics
NPI:1326569872
Name:LONG, SARAH ELIZABETH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:LONG
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1544 WINCHESTER AVE STE 808
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7931
Mailing Address - Country:US
Mailing Address - Phone:606-325-4091
Mailing Address - Fax:606-325-4092
Practice Address - Street 1:1544 WINCHESTER AVE STE 808
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7931
Practice Address - Country:US
Practice Address - Phone:606-325-4091
Practice Address - Fax:606-325-4092
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY290461101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional