Active NPI
Michelene M Longo, LADC
- Addiction (Substance Use Disorder) Counselor
- East Hartford, CT
National Provider Identifier
1104263284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 000834
- Practice address
- 991 Main St
East Hartford, CT 06108-2274 - Phone
- (860) 528-3238
- Fax
- (860) 528-3267
- NPI assigned
- May 29, 2013
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 000834 | CT | Primary |
Addresses
Primary practice location
991 Main St
East Hartford, CT 06108-2274
Mailing address
991 Main St
East Hartford, CT 06108-2274
Phone (860) 528-3238
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 |
|---|---|---|---|
| 000834 | CT | MD | Sports Physician Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Town of Stafford | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Stafford Springs, CT
- NPI 1073971081
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369785600000",
"number": "1104263284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "991 MAIN ST",
"city": "EAST HARTFORD",
"state": "CT",
"postal_code": "061082274",
"telephone_number": "860-528-3238",
"fax_number": "860-528-3267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "991 MAIN ST",
"city": "EAST HARTFORD",
"state": "CT",
"postal_code": "061082274",
"telephone_number": "860-528-3238",
"fax_number": "860-528-3267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONGO",
"first_name": "MICHELENE",
"middle_name": "M",
"credential": "LADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-29",
"last_updated": "2013-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CT",
"license": "000834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.