Active NPI
Kim Marie Long, LCPC
- Professional Counselor
- Frederick, MD
National Provider Identifier
1225508146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC0743
- Practice address
- 300 W 9TH St
Frederick, MD 21701-4541 - Phone
- (667) 600-3310
- Fax
- (301) 694-8221
- NPI assigned
- Dec 4, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC0743 | MD | Primary |
Addresses
Primary practice location
300 W 9TH St
Frederick, MD 21701-4541
Mailing address
300 W 9TH St
Frederick, MD 21701-4541
Phone (667) 600-3310
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 |
|---|---|---|---|
| LC0743 | MD | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543881600000",
"number": "1225508146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 W 9TH ST",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217014541",
"telephone_number": "667-600-3310",
"fax_number": "301-694-8221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W 9TH ST",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217014541",
"telephone_number": "667-600-3310",
"fax_number": "301-694-8221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "KIM",
"middle_name": "MARIE",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-04",
"last_updated": "2018-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC0743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.