Provider Demographics
NPI:1346248598
Name:LONG, LORI LYNN (LPC)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:LYNN
Last Name:LONG
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:292 JESSI RD
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:MO
Mailing Address - Zip Code:65653-5096
Mailing Address - Country:US
Mailing Address - Phone:417-224-4167
Mailing Address - Fax:
Practice Address - Street 1:1701 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:MONETT
Practice Address - State:MO
Practice Address - Zip Code:65708-1144
Practice Address - Country:US
Practice Address - Phone:417-476-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001999101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional