Individual provider Active NPI

Vickie Longwill, LCDC, ADC III, ICADC

  • Addiction (Substance Use Disorder) Counselor
  • Houston, TX
National Provider Identifier
1174716377
Registry record updated Jan 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
2070 Issued in TX
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

Updated by the provider on Jan 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
115651OtherTXTHE INTERNATIONAL CERTIFICATION & RECEPROCITY CONSORTIUM
2070OtherTXDEPARTMENT OF STATE HEALTH SERVICES
9551-0991OtherTXTEXAS 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

LicenseStateTypeSpecialty
2070TXMDAddiction (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.

Verify at the official NPI Registry.