Active NPI
Shelly Ann Long, LLBSW
- Social Worker
- Flint, MI
National Provider Identifier
1083075428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6802088852
- Practice address
- 420 W 5TH Ave
Flint, MI 48503-2445 - Phone
- (181) 025-7370
- NPI assigned
- Mar 13, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6802088852 | MI | Primary |
Addresses
Primary practice location
420 W 5TH Ave
Flint, MI 48503-2445
Mailing address
2012 Bone Rd
Holly, MI 48442-9106
Phone (248) 417-1196
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6802088852 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457827200000",
"number": "1083075428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2012 BONE RD",
"city": "HOLLY",
"state": "MI",
"postal_code": "484429106",
"telephone_number": "248-417-1196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 W 5TH AVE",
"city": "FLINT",
"state": "MI",
"postal_code": "485032445",
"telephone_number": "181-025-7370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "SHELLY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "LLBSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-13",
"last_updated": "2016-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6802088852",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.