Individual provider Active NPI

Kathryn Wood Long, MED

  • Counselor
  • Charlotte, NC
National Provider Identifier
1346417821
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
2772 Issued in NC
Practice address
1011 Guilford Rd
Charlotte, NC 28209-1204
Phone
(704) 333-8113
NPI assigned
May 13, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 2772 NC Primary

Addresses

Primary practice location

1011 Guilford Rd
Charlotte, NC 28209-1204

Mailing address

1011 Guilford Rd
Charlotte, NC 28209-1204
Phone (704) 333-8113

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
2772NCMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1346417821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 GUILFORD RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282091204",
            "telephone_number": "704-333-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 GUILFORD RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282091204",
            "telephone_number": "704-333-8113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "KATHRYN",
        "middle_name": "WOOD",
        "name_prefix": "Ms.",
        "credential": "MED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-13",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "2772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.