1194836031 NPI number — MRS. LUANNE FAYE BENDER LONG LPC, LMFT

Table of content: WAYNE ZIMMERMAN PT (NPI 1417272220)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194836031 NPI number — MRS. LUANNE FAYE BENDER LONG LPC, LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BENDER LONG
Provider First Name:
LUANNE
Provider Middle Name:
FAYE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC, LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194836031
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/11/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 MACTANLY PL STE B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STAUNTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24401-2383
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-885-3481
Provider Business Mailing Address Fax Number:
540-885-3508

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 MACTANLY PL STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STAUNTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24401-2383
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-885-3481
Provider Business Practice Location Address Fax Number:
540-885-3508
Provider Enumeration Date:
08/31/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  0701002566 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: 0717000738 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 560382 . This is a "VALUE OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: O88503M . This is a "SOUTHERN HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 193663 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 2108713 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".