Provider Demographics
NPI:1568078285
Name:LONGPRE, WILLIAM G
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:G
Last Name:LONGPRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 N 3RD ST STE 10
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-3400
Mailing Address - Country:US
Mailing Address - Phone:208-417-3216
Mailing Address - Fax:208-601-6163
Practice Address - Street 1:1801 N 3RD ST STE 10
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-3400
Practice Address - Country:US
Practice Address - Phone:208-417-3216
Practice Address - Fax:208-601-6163
Is Sole Proprietor?:No
Enumeration Date:2020-09-17
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID8331352101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor