Active NPI
Vickie Longwill, LCDC, ADC III, ICADC
- Addiction (Substance Use Disorder) Counselor
- Houston, TX
National Provider Identifier
1174716377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 2070
- Practice address
- 2040 North Loop West
Suite 335
Houston, TX 77018-8127 - Phone
- (713) 628-2980
- Fax
- (713) 681-3800
- NPI assigned
- Aug 21, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 2070 | TX | Primary |
Addresses
Primary practice location
2040 North Loop West
Suite 335
Houston, TX 77018-8127
Mailing address
2040 North Loop West
Suite 335
Houston, TX 77018-8127
Phone (713) 628-2980
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 115651 | Other | TX | THE INTERNATIONAL CERTIFICATION & RECEPROCITY CONSORTIUM |
| 2070 | Other | TX | DEPARTMENT OF STATE HEALTH SERVICES |
| 9551-0991 | Other | TX | TEXAS CERTIFICATION BOARD OF ADDICTION PROFESSIONALS |
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 |
|---|---|---|---|
| 2070 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296086400000",
"number": "1174716377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2040 NORTH LOOP WEST",
"address_2": "SUITE 335",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770188127",
"telephone_number": "713-628-2980",
"fax_number": "713-681-3800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2040 NORTH LOOP WEST",
"address_2": "SUITE 335",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770188127",
"telephone_number": "713-628-2980",
"fax_number": "713-681-3800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONGWILL",
"first_name": "VICKIE",
"name_prefix": "Mrs.",
"credential": "LCDC, ADC III, ICADC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-21",
"last_updated": "2011-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "2070",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THE INTERNATIONAL CERTIFICATION & RECEPROCITY CONSORTIUM",
"identifier": "115651",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF STATE HEALTH SERVICES",
"identifier": "2070",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS CERTIFICATION BOARD OF ADDICTION PROFESSIONALS",
"identifier": "9551-0991",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.