Active NPI
Jeannie Long, LCSW
- Clinical Social Worker
- Overland Park, KS
National Provider Identifier
1073890786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1309
- Practice address
- 5808 W 110TH St
Overland Park, KS 66211-2504 - Phone
- (913) 696-8000
- NPI assigned
- Nov 9, 2011
- Last updated
- Sep 19, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1309 | KS | Primary |
| Clinical Social Worker | 1041C0700X | 2009025845 | MO |
Addresses
Primary practice location
5808 W 110TH St
Overland Park, KS 66211-2504
Mailing address
2401 Gillham Rd
Provider Enrollment
Kansas City, MO 64108-4619
Phone (816) 701-5200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009025845 | MO | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Children's Mercy Hospital | Current | Accepting new patients | |
| The Children's Mercy Hospital | Current | Accepting new patients | |
| BPH LLC | Past | Accepting new patients |
Locations
5808 W 110th St
Overland Park, KS 66211
Phone (913) 696-8000
2401 Gillham Rd
Kansas City, MO 64108
Phone (816) 234-3380
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Children's Mercy Riverside Pharmacy - Mail
- Mail Order Pharmacy
- Riverside, MO
- NPI 1235923194
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474243200000",
"number": "1073890786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2401 GILLHAM RD",
"address_2": "PROVIDER ENROLLMENT",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641084619",
"telephone_number": "816-701-5200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5808 W 110TH ST",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662112504",
"telephone_number": "913-696-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "JEANNIE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-09",
"last_updated": "2016-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KS",
"license": "1309",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2009025845",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Overland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.