Provider Demographics
NPI:1285526525
Name:LONGO, JESSICA GLORIA (LMSW)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:GLORIA
Last Name:LONGO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 96TH ST APT 5H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-7518
Mailing Address - Country:US
Mailing Address - Phone:917-379-7106
Mailing Address - Fax:
Practice Address - Street 1:120 96TH ST APT 5H
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7518
Practice Address - Country:US
Practice Address - Phone:917-379-7106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY128158104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker