Lise D Delong, PH.D. CPCRT

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Practice address

1678 Fry Rd Ste C
Greenwood, IN 46142-1176

Phone

(317) 888-7420

NPI assigned

Jan 17, 2011

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1295222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295222400000",
    "number": "1295030666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1678 FRY RD STE C",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461421176",
            "telephone_number": "317-888-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1678 FRY RD STE C",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461421176",
            "telephone_number": "317-888-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELONG",
        "first_name": "LISE",
        "middle_name": "D",
        "credential": "PH.D. CPCRT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-17",
        "last_updated": "2011-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Decamp, RBT
• Abigail Deckard, RD
• Jamie Marie Deerr, DPT
• Ella Nicole Dehner
• Gabrielle Eugenia Deiter
• Ashley Delp
• Matthew Delph
• Laura Kay Demougin
• Dustin Demuth, PA-C
• Nicholas Denney, LSW

• Developmental Disabilities Clinic/Center in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Developmental Disabilities Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2011; 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.