Active NPI
Susan Westlake Longerbone, LOC NCC CEAP MAC
- Professional Counselor
- Greensboro, NC
National Provider Identifier
1245221530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- NC961
- Practice address
- 4010 Walker Av
Greensboro, NC 27403 - Phone
- (336) 202-1959
- Fax
- (336) 662-0232
- NPI assigned
- Nov 4, 2005
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | NC961 | NC | Primary |
Addresses
Primary practice location
4010 Walker Av
Greensboro, NC 27403
Mailing address
4536 Walpole Rd
High Point, NC 27265
Phone (336) 202-1959
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 023332 | Other | VMC | |
| 102040 | Other | MHN | |
| 479252 | Other | VALUE OPTIONS | |
| 52689 | Other | NC | BLUECROSS BLUESHIELD |
| 51335 | Other | MT CARMEL BEHAVORIAL HLTH | |
| 6102049 | Medicaid | NC |
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 |
|---|---|---|---|
| NC961 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245221530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4536 WALPOLE RD",
"city": "HIGH POINT",
"state": "NC",
"postal_code": "27265",
"telephone_number": "336-202-1959",
"fax_number": "336-662-0232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4010 WALKER AV",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "27403",
"telephone_number": "336-202-1959",
"fax_number": "336-662-0232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONGERBONE",
"first_name": "SUSAN",
"middle_name": "WESTLAKE",
"name_prefix": "Ms.",
"credential": "LOC NCC CEAP MAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-11-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "NC961",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VMC",
"identifier": "023332",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN",
"identifier": "102040",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "479252",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "52689",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MT CARMEL BEHAVORIAL HLTH",
"identifier": "51335",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6102049",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.