Active NPI
Amy Renee Long, LPC
- Professional Counselor
- Dalton, GA
National Provider Identifier
1245696558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC007501
- Practice address
- 2406 Cleveland Hwy
Suite 305
Dalton, GA 30721-8155 - Phone
- (706) 277-4883
- NPI assigned
- Jan 4, 2016
- 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 | LPC007501 | GA | Primary |
Addresses
Primary practice location
2406 Cleveland Hwy
Suite 305
Dalton, GA 30721-8155
Mailing address
1659 Farley Dr
Tunnel Hill, GA 30755-7769
Phone (423) 802-9080
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 |
|---|---|---|---|
| LPC007501 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451865600000",
"number": "1245696558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1659 FARLEY DR",
"city": "TUNNEL HILL",
"state": "GA",
"postal_code": "307557769",
"telephone_number": "423-802-9080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2406 CLEVELAND HWY",
"address_2": "SUITE 305",
"city": "DALTON",
"state": "GA",
"postal_code": "307218155",
"telephone_number": "706-277-4883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "AMY",
"middle_name": "RENEE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-04",
"last_updated": "2016-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC007501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dalton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.