Charles a. Long, a Professional Marriage and Family Therapy Corporatio

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

MFC33504 Issued in CA

Legal business name

CHARLES A. LONG, A PROFESSIONAL MARRIAGE AND FAMILY THERAPY CORPORATIO

Practice address

5480 Baltimore Dr
Suite 202
La Mesa, CA 91942-2020

Phone

(619) 462-0199

NPI assigned

Jul 19, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Charles Anthony Lopng, PSY D

Title

Marriage and Family Therapist

Phone

(619) 462-0199

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Anthony Long, MFT

  • Marriage & Family Therapist
  • La Mesa, CA
  • NPI 1740271337
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374192000000",
    "number": "1144662131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5480 BALTIMORE DR",
            "address_2": "SUITE 202",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422020",
            "telephone_number": "619-462-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 BALTIMORE DR",
            "address_2": "SUITE 202",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422020",
            "telephone_number": "619-462-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES A. LONG, A PROFESSIONAL MARRIAGE AND FAMILY THERAPY CORPORATIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-19",
        "last_updated": "2013-07-19",
        "status": "A",
        "authorized_official_last_name": "LOPNG",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "MARRIAGE AND FAMILY THERAPIST",
        "authorized_official_telephone_number": "619-462-0199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY D"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "MFC33504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.

Verify at the official NPI Registry.