Individual ProviderTabetha Kay LongCounselorBehavioral Health & Social Service ProvidersPractice Address711 State Ave NE, Olympia, WA 98506-3984(360) 943-0780PECOS EnrollmentBased on the most recent information from CMS, provider Tabetha Kay Long does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1578343158Provider TypeIndividualFull NameLong, Tabetha KayGenderFemaleSole ProprietorNoEnumeration Date10/2/2023Last Updated10/2/2023Contact InformationPractice LocationPractice Address711 State Ave NE, Olympia, WA 98506-3984Phone(360) 943-0780FaxUnlisted FaxMailing LocationMailing Address711 State Ave NE, Olympia, WA 98506-3984Phone(360) 943-0780FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101Y00000XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseCG61493621Washington