Kristine Long

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

110508 Issued in IA

Practice address

1105 N Ankeny Blvd Ste 100
Ankeny, IA 50023-4003

Phone

(515) 255-8399

NPI assigned

Apr 28, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Psychiatric Associates of Iowa, PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • North Liberty, IA
  • NPI 1568121457
  Medicare reassignment NPD
• Psychiatric Associates of Iowa, PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • North Liberty, IA
  • NPI 1720709074
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1245975937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2812 50TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503102561",
            "telephone_number": "515-720-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 N ANKENY BLVD STE 100",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500234003",
            "telephone_number": "515-255-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "KRISTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-28",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "110508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klong@lifeworksdm.com",
            "affiliation": "N",
            "endpointDescription": "e-mail",
            "address_1": "1105 N Ankeny Blvd Ste 100",
            "city": "Ankeny",
            "state": "IA",
            "country_code": "US",
            "postal_code": "500234003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marnie M Loftus, DO
• Celina Logworong
• Melissa Lohmann, LMHC
• Anne Lolwing, LMFT
• Lauren Loney, DDS
• Megan Rae Longobardi, R.D., L.D.
• Ashley Elizabeth Loos, PT, DPT
• Jennifer Lynn Lopez
• Kaela Lopez
• Lori Eisbrener, LLC

• Mental Health Counselor in Ankeny, IA
• Providers in Ankeny, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.