Active NPI
Longevity Counseling Services, LLC
- Clinical Social Worker
- Niles, MI
National Provider Identifier
1184499394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- LONGEVITY COUNSELING SERVICES, LLC
- Practice address
- 121 S Saint Joseph Ave
Niles, MI 49120-2848 - Phone
- (574) 334-9594
- NPI assigned
- Nov 17, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sarah Elizabeth Long, MSW, LCSW
- Title
- Owner
- Phone
- (574) 334-9594
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
121 S Saint Joseph Ave
Niles, MI 49120-2848
Mailing address
121 S Saint Joseph Ave
Niles, MI 49120-2848
Phone (574) 334-9594
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Niles, MI
- NPI 1740936574
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700179200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1700179200000",
"number": "1184499394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 S SAINT JOSEPH AVE",
"city": "NILES",
"state": "MI",
"postal_code": "491202848",
"telephone_number": "574-334-9594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 S SAINT JOSEPH AVE",
"city": "NILES",
"state": "MI",
"postal_code": "491202848",
"telephone_number": "574-334-9594"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LONGEVITY COUNSELING SERVICES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-11-17",
"last_updated": "2023-11-17",
"certification_date": "2023-11-17",
"status": "A",
"authorized_official_last_name": "LONG",
"authorized_official_first_name": "SARAH",
"authorized_official_middle_name": "ELIZABETH",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "574-334-9594",
"authorized_official_credential": "MSW, LCSW"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"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 Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.