Active NPI
Melissa A Longley, MSW, LMSW
- Clinical Social Worker
- Niles, MI
National Provider Identifier
1124218391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801089455
- Practice address
- 333 N. Second Street
Suite 303
Niles, MI 49120 - Phone
- (574) 220-5041
- NPI assigned
- Jul 25, 2007
- Last updated
- Oct 15, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | 34006003A | IN | |
| Clinical Social Worker | 1041C0700X | 6801089455 | MI | Primary |
Addresses
Primary practice location
333 N. Second Street
Suite 303
Niles, MI 49120
Mailing address
333 N. Second Street
Suite 303
Niles, MI 49120
Phone (574) 220-5041
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101124000829 | MI | Practitioner - Clinical Social Worker | 3971799370 | Practice locations: Niles, MI |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
306 E Main St
Suite 240
Niles, MI 49120-2368
Phone (269) 687-5050
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34006003A | IN | MD | Clinical Social Worker |
| 6801089455 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| M Longley Counseling and Consulting Services, PLLC | Clinical | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Social Worker
- Niles, MI
- NPI 1720362841
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287100800000",
"number": "1124218391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 N. SECOND STREET",
"address_2": "SUITE 303",
"city": "NILES",
"state": "MI",
"postal_code": "49120",
"telephone_number": "574-220-5041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 N. SECOND STREET",
"address_2": "SUITE 303",
"city": "NILES",
"state": "MI",
"postal_code": "49120",
"telephone_number": "574-220-5041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONGLEY",
"first_name": "MELISSA",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "MSW, LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-25",
"last_updated": "2010-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34006003A",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801089455",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Niles, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.