Individual provider Active NPI

Jaymie Long, CADC

  • Addiction (Substance Use Disorder) Counselor
  • Marlton, NJ
National Provider Identifier
1275104929
Registry record updated Jul 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
37CA00169400 Issued in NJ
Practice address
925 Route 73 N Ste H
Marlton, NJ 08053-1277
Phone
(856) 842-7881
NPI assigned
Jul 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37CA00169400 NJ Primary

Addresses

Primary practice location

925 Route 73 N Ste H
Marlton, NJ 08053-1277

Mailing address

925 Route 73 N Ste H
Marlton, NJ 08053-1277
Phone (856) 842-7881

Other practice location 1

603 N Broad St Ste 200
Woodbury, NJ 08096-1619
Phone (856) 842-7881

Other practice location 2

925 Route 73 N Ste H
Marlton, NJ 08053-1277
Phone (856) 842-7881

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

LicenseStateTypeSpecialty
37CA00169400NJMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
N8 Care Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1625443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625443200000",
    "number": "1275104929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 ROUTE 73 N STE H",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531277",
            "telephone_number": "856-842-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 ROUTE 73 N STE H",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531277",
            "telephone_number": "856-842-7881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "603 N Broad St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "NJ",
            "postal_code": "080961619",
            "country_code": "US",
            "telephone_number": "856-842-7881",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "925 Route 73 N Ste H",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080531277",
            "country_code": "US",
            "telephone_number": "856-842-7881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "JAYMIE",
        "credential": "CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-05",
        "last_updated": "2021-07-05",
        "certification_date": "2021-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37CA00169400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.