Justina Louise Delong

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-23-65312 Issued in AR

Practice address

908 N Reynolds Rd
Bryant, AR 72022-3034

Phone

(501) 847-9711

Fax

(501) 847-6929

NPI assigned

Jan 15, 2014

Last updated

Apr 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1285056861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. DRAWER 2109",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72811",
            "telephone_number": "479-967-2322",
            "fax_number": "479-967-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 N REYNOLDS RD",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720223034",
            "telephone_number": "501-847-9711",
            "fax_number": "501-847-6929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELONG",
        "first_name": "JUSTINA",
        "middle_name": "LOUISE",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-15",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AR",
            "license": "1-23-65312",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "AR",
            "license": "RBT-19-99028",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207397706",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "299960790",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Lee Davis, M.ED, BCBA
• Dawn Lindsey DNP, Aprn PLLC
• Sarah Dean, OTD, OTR/L
• Bradley Alexander Deckelman, D.D.S.
• Estrella Delacruz
• Taeitha Eve Demery
• Carol R. Dennis, B. S., R. D. H.
• Darshankumar Desai, PHARMD
• Tara D Devaux, MA CCC-SLP
• Tiffany Lynn Dews, MSOTR/L

• Behavior Analyst in Bryant, AR
• Providers in Bryant, AR by specialty
• Behavior Analyst in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.