Individual provider Active NPI

Melissa A Longley, MSW, LMSW

  • Clinical Social Worker
  • Niles, MI
National Provider Identifier
1124218391
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801089455 Issued in MI
Practice address
333 N. Second Street
Suite 303
Niles, MI 49120
Phone
(574) 220-5041
NPI assigned
Jul 25, 2007
Last updated
Oct 15, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
34006003AINMDClinical Social Worker
6801089455MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.